US20210114973A1 - Pharmaceutical formulations - Google Patents

Pharmaceutical formulations Download PDF

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Publication number
US20210114973A1
US20210114973A1 US16/842,695 US202016842695A US2021114973A1 US 20210114973 A1 US20210114973 A1 US 20210114973A1 US 202016842695 A US202016842695 A US 202016842695A US 2021114973 A1 US2021114973 A1 US 2021114973A1
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Prior art keywords
compound
acid
particle size
niclosamide
size distribution
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US16/842,695
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Gary Glick
Anthony William OPIPARI, Jr.
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Entero Therapeutics Inc
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First Wave Bio Inc
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Assigned to FIRST WAVE BIO, INC. reassignment FIRST WAVE BIO, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: GLICK, GARY, OPIPARI, ANTHONY W., JR.
Publication of US20210114973A1 publication Critical patent/US20210114973A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/16—Amides, e.g. hydroxamic acids
    • A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
    • A61K31/167—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C235/00—Carboxylic acid amides, the carbon skeleton of the acid part being further substituted by oxygen atoms
    • C07C235/42—Carboxylic acid amides, the carbon skeleton of the acid part being further substituted by oxygen atoms having carbon atoms of carboxamide groups bound to carbon atoms of six-membered aromatic rings and singly-bound oxygen atoms bound to the same carbon skeleton
    • C07C235/44—Carboxylic acid amides, the carbon skeleton of the acid part being further substituted by oxygen atoms having carbon atoms of carboxamide groups bound to carbon atoms of six-membered aromatic rings and singly-bound oxygen atoms bound to the same carbon skeleton with carbon atoms of carboxamide groups and singly-bound oxygen atoms bound to carbon atoms of the same non-condensed six-membered aromatic ring
    • C07C235/58—Carboxylic acid amides, the carbon skeleton of the acid part being further substituted by oxygen atoms having carbon atoms of carboxamide groups bound to carbon atoms of six-membered aromatic rings and singly-bound oxygen atoms bound to the same carbon skeleton with carbon atoms of carboxamide groups and singly-bound oxygen atoms bound to carbon atoms of the same non-condensed six-membered aromatic ring with carbon atoms of carboxamide groups and singly-bound oxygen atoms, bound in ortho-position to carbon atoms of the same non-condensed six-membered aromatic ring
    • C07C235/64—Carboxylic acid amides, the carbon skeleton of the acid part being further substituted by oxygen atoms having carbon atoms of carboxamide groups bound to carbon atoms of six-membered aromatic rings and singly-bound oxygen atoms bound to the same carbon skeleton with carbon atoms of carboxamide groups and singly-bound oxygen atoms bound to carbon atoms of the same non-condensed six-membered aromatic ring with carbon atoms of carboxamide groups and singly-bound oxygen atoms, bound in ortho-position to carbon atoms of the same non-condensed six-membered aromatic ring having the nitrogen atom of at least one of the carboxamide groups bound to a carbon atom of a six-membered aromatic ring
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0031—Rectum, anus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/007—Pulmonary tract; Aromatherapy
    • A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy

Definitions

  • niclosamide compounds or pharmaceutically acceptable salts and/or co-crystals thereof, e.g., niclosamide
  • niclosamide having one or more properties that include, but are not limited to: a particular purity (e.g., a chemical purity of greater than about 99.0%) or a particular particle size (e.g., a particular particle size distribution and/or a particular particle size range and/or a specific surface area range).
  • the niclosamide compounds described herein e.g., niclosamide
  • dosage forms e.g., unit dosage forms
  • This disclosure also features methods of making and using the same.
  • Ulcerative colitis (UC) and Crohn's disease (CD) are the predominant chronic, inflammatory bowel diseases (IBD) in humans. These disorders are autoimmune in nature and occur in the absence of infection. IBD effects up to 2,000,000 Americans (increasing ⁇ 15% annually) and it is associated with unacceptably high rates of morbidity and mortality. IBD is also a significant burden on the U.S. health care system as the most effective treatments are biological drugs that are quite costly.
  • IBD occurs as the result of inappropriate immune responses in genetically susceptible individuals mediated by complex interactions between environmental stimuli, microbial factors, and the intestinal immune system.
  • the hallmark of IBD is represented by excessive immune responses that mediate gastrointestinal tissue damage, either directly or through the release of soluble, pro-inflammatory mediators.
  • T cells are a type of immune cell that infiltrate the intestinal mucosa and are key drivers of gastrointestinal tissue damage in IBD. These cells persist and accumulate in the intestinal mucosa because normal physiologic mechanisms designed to censor or eliminate activated T cells are inoperative in the context of IBD. While the exact basis for T cell accumulation in IBD is not fully elucidated, chronic activation by microbial stimuli along with the cytokine milieu at the sites of inflammation within gastrointestinal tissue are thought to be important. Regardless of how these cells persist, enhancing T cell death in the intestinal mucosa is linked with resolution of IBD and drugs that are most effective in managing IBD function (in part), by killing pathogenic T cells resident in the gut.
  • Immunosuppressive drugs can also be used to treat moderate to severe cases of IBD, often as a replacement for steroid therapy.
  • immunosuppressive drugs e.g., azathioprine
  • azathioprine usually cannot ensure control of symptoms, and treatment is accompanied by numerous contraindications and severe side effects.
  • Drugs that often show the best efficacy in treating IBD are systemically administered (via injection or infusion) monoclonal antibodies that block TNF-alpha, a pro-inflammatory cytokine overproduced during all forms of IBD (e.g., UC, CD, graft-versus-host disease, celiac disease, iatrogenic colitis such as that induced by checkpoint inhibitors, etc.).
  • a pro-inflammatory cytokine e.g., UC, CD, graft-versus-host disease, celiac disease, iatrogenic colitis such as that induced by checkpoint inhibitors, etc.
  • Reducing levels of TNF-alpha in the context of IBD has two consequences. First, as an inflammatory cytokine, TNF-alpha mediates tissue damage. Second, high levels of TNF-alpha help disease causing T cells to survive and blocking TNF-alpha activity eventually leads to T cell death. Indeed, the induction of cell death by anti-TNF-alpha drugs like in
  • anti-TNF-alpha drugs Although effective, use of anti-TNF-alpha drugs is associated with severe, systemic side effects including, re-activation of latent pathogens, hypersensitivity phenomena, cancer, and the formation of autoantibodies. Some patients are inherently resistant to anti-TNF-alpha drugs and over time, almost half of all patients that do show a response, develop resistance.
  • Niclosamide (5-chloro-N-(2-chloro-4-nitrophenyl)-2-hydrobenzamide) is a halogenated salicylanilide that belongs to a group of medicines known as anthelmintics. Anthelmintics are medicines used in the treatment of worm infections.
  • Niclosamide which has low systemic bioavailabilty and an excellent safety profile, is used to treat broad or fish tapeworm, dwarf tapeworm, and beef tapeworm infections.
  • Niclosamide inhibits oxidative phosphorylation and stimulates adenosine triphosphatase activity in the mitochondria of cestodes (e.g., tapeworm), killing the scolex and proximal segments of the tapeworm both in vitro and in vivo (see, Li, Y., et al., Cancer Lett. 2014 349, 8-14.).
  • Oral administration is among the preferred routes for administration of pharmaceuticals since this route is generally convenient and acceptable to patients.
  • the drug substance typically needs to be absorbed through at least one membrane.
  • absorption of the drug substance typically occurs once the solid oral dosage form is dissolved. The above can sometimes have considerable effects on drug pharmacokinetics and may cause a reduction in the actual amount of drug substance that is absorbed.
  • niclosamide compounds or pharmaceutically acceptable salts and/or cocrystals thereof, e.g., niclosamide or pharmaceutically acceptable salt and/or cocrystal thereof), having one or more properties that include, but are not limited to: a particular purity (e.g., a chemical purity of greater than about 99.0%) or a particular particle size (e.g., a particular particle size distribution and/or a particular particle size range and/or a specific surface area range).
  • the niclosamide compounds described herein e.g., niclosamide
  • niclosamide compounds e.g., niclosamide
  • administration e.g., oral administration
  • niclosamide compounds e.g., niclosamide
  • GI gastrointestinal
  • inflammatory bowel disease e.g., ulcerative colitis and Crohn's disease
  • This disclosure also features methods of making and using the niclosamide compounds.
  • this disclosure features highly pure niclosamide compounds, or pharmaceutically acceptable salts thereof.
  • this disclosure features a highly pure niclosamide, or a pharmaceutically acceptable salt thereof:
  • highly pure niclosamide compounds e.g., niclosamide
  • starting materials e.g., for preparation of niclosamide compounds, e.g., niclosamide, having a reduced particle size range (e.g., as determined by measuring the particle size distribution).
  • this disclosure features niclosamide compounds, or a pharmaceutically acceptable salt thereof, having a reduced particle size (e.g., having a reduced particle size range, having a reduced particle size distribution).
  • this disclosure features niclosamide, or a pharmaceutically acceptable salt thereof:
  • having a reduced particle size size e.g., having a reduced particle size range, having a reduced particle size distribution.
  • this disclosure features highly pure niclosamide compounds, or a pharmaceutically acceptable salt thereof, having a reduced particle size (e.g., having a reduced particle size range, having a reduced particle size distribution).
  • this disclosure features highly pure niclosamide, or a pharmaceutically acceptable salt thereof:
  • having a reduced particle size e.g., having a reduced particle size range, having a reduced particle size distribution.
  • this disclosure features a co-crystal that includes a niclosamide compound (e.g., niclosamide having any one or more or the properties described herein), or a pharmaceutically acceptable salt thereof and a pharmaceutically acceptable coformer.
  • a niclosamide compound e.g., niclosamide having any one or more or the properties described herein
  • a pharmaceutically acceptable salt thereof e.g., a pharmaceutically acceptable salt thereof
  • a pharmaceutically acceptable coformer e.g., niclosamide having any one or more or the properties described herein
  • the cocrystal has a reduced particle size as described anywhere herein (e.g., the cocrystal itself can be reduced to have the reduced particle size range, and/or the reduced particle size distribution described herein for niclosamide compounds).
  • Non-limiting examples of the co-former include sphingosine 1-phosphate (SiP) receptor modulators (e.g., etrasimod or ozanimod); steroidal anti-inflammatory agents (e.g, beclomethasone 17 or budesonide); non-steroidal anti-inflammatory agents (e.g., 5-ASA); receptor-interacting protein kinase 1 (RIPK1) inhibitors (e.g., GSK2982772); EP4 modulators (e.g., KAG-308); toll-like receptor (e.g., TLR4, TLR9) modulators (e.g., JKB-122, cobitolimod); Janus kinase (JAK) inhibitors (e.g., TD-1473, tofacitinib, upadacitinib, filgotinib, PF-06651600, and PF-06700841); lanthionine synthetase C-like 2 (LANCL2) modulators (e
  • niclosamide can be purified to levels that exceed current purity benchmarks, e.g., containing relatively low amounts of common impurities, such as one or more of the following: 5-chloro-salicylic acid, 2-chloro-4 nitro-aniline, and hydrated niclosamide solid forms.
  • relatively low amounts of 2-chloro-4 nitro-aniline are present.
  • the subject matter disclosed and claimed herein is also and independently based, in part, on the surprising discovery that decreasing the particle size of niclosamide resulted in a significant increase in local exposure of niclosamide in colon tissue.
  • rectal administration of niclosamide having a particle size distribution D(0.9) of about 5 ⁇ m was found to provide a local concentration of niclosamide in colon tissue that was about 200 times greater than that achieved with niclosamide having a particle size distribution D(0.9) of about 30 ⁇ m.
  • niclosamide compounds e.g., niclosamide
  • niclosamide compounds described herein having a reduced particle size can therefore be readily and efficiently administered, such that the resultant local bioavailability of the administered niclosamide compounds (e.g., niclosamide) in the GI tract, e.g., colon, is relatively high (e.g., as compared with resultant systemic bioavailability of the administered niclosamide compounds (e.g., niclosamide)).
  • niclosamide compounds e.g., niclosamide
  • a desired area of treatment e.g., gastrointestinal tract, e.g., colon
  • the amount of reduced particle size niclosamide compounds (e.g., niclosamide) needed to achieve a desired API level in the GI tract, e.g., colon will be less than the amount needed for niclosamide compounds (e.g., niclosamide) having larger particle sizes.
  • the niclosamide compounds e.g., niclosamide
  • the niclosamide compounds described herein e.g., reduced particle size niclosamide compounds (e.g., niclosamide)
  • administration e.g., oral administration
  • a niclosamide compound e.g., niclosamide
  • a niclosamide compound e.g., niclosamide
  • a niclosamide compound e.g., niclosamide
  • the foregoing can potentially be achieved using a lower dosage with the reduced particle size niclosamide compounds (e.g., niclosamide) described herein.
  • niclosamide compounds e.g., niclosamide
  • methods, and compositions described herein are also expected to be functional in diverse patient populations and/or less sensitive to blocks in cell death mechanisms. Further, the ability to utilize traditional small molecules, such as niclosamide, can help reduce cost and facilitate patient administration.
  • the methods and compositions described herein are suitable for use in combination therapy with various other therapeutic regimens (e.g., chemotherapy and/or radiation).
  • the chemical entities and methods described herein can be used to treat side effects produced by such therapeutic regimens, e.g., inflammatory bowel diseases induced by chemotherapeutic immunomodulators, e.g., checkpoint inhibitors, which in some cases can be prohibitively severe.
  • the methods and compositions described herein are suitable for use in combination therapy with one or more additional therapeutic agents.
  • therapeutic agents useful for treating or preventing inflammatory bowel disease (IBD) e.g., Crohn's disease, ulcerative colitis.
  • Non-limiting examples of the additional therapeutic agents include: sphingosine 1-phosphate (SiP) receptor modulators (e.g., etrasimod or ozanimod); steroidal anti-inflammatory agents (e.g, beclomethasone 17 or budesonide); non-steroidal anti-inflammatory agents (e.g., 5-ASA); receptor-interacting protein kinase 1 (RIPK1) inhibitors (e.g., GSK2982772); EP4 modulators (e.g., KAG-308); toll-like receptor (e.g., TLR4, TLR9) modulators (e.g., JKB-122, cobitolimod); Janus kinase (JAK) inhibitors (e.g., TD-1473, tofacitinib, upadacitinib, filgotinib, PF-06651600, and PF-06700841); lanthionine synthetase C-like 2 (LANCL2) modulators (e
  • chemical entities, methods, and compositions described herein are also expected to be useful in certain treatment-resistant patient populations, e.g., one that is nonresponsive or resistant to treatment an anti-TNFalpha therapy (e.g., Humira, Enbrel, Remicade) or anti-integrin therapy (e.g., Entyvio, etrolizumab) or corticosteroids.
  • an anti-TNFalpha therapy e.g., Humira, Enbrel, Remicade
  • anti-integrin therapy e.g., Entyvio, etrolizumab
  • corticosteroids corticosteroids
  • methods for inducing cell death of one or more T cells e.g., in the digestive and/or gastrointestinal tract (GI)
  • the methods include contacting the one or more T cells with an effective amount of a niclosamide compound or a pharmaceutically acceptable salt and/or cocrystal thereof, e.g., niclosamide or a pharmaceutically acceptable salt and/or cocrystal thereof as described herein (e.g., a niclosamide compound, such as niclosamide, having a reduced particle size (e.g., having a reduced particle size range, having a reduced particle size distribution).
  • the niclosamide compound, such as niclosamide has or further has a high chemical purity.
  • a niclosamide compound or a pharmaceutically acceptable salt and/or cocrystal thereof e.g., niclosamide or a pharmaceutically acceptable salt and/or cocrystal thereof as described herein (e.g., a niclosamide compound, such as niclosamide, having a reduced particle size (e.g., having a reduced particle size range, having a reduced particle size distribution).
  • the niclosamide compound, such as niclosamide has or further has a high chemical purity.
  • the methods include orally administering the niclosamide compound.
  • an autoimmune disorder e.g., colitis, e.g., autoimmune colitis, e.g, an inflammatory bowel disease, e.g., Crohn's disease, ulcerative colitis.
  • the methods include administering (e.g., orally) to the subject an effective amount of a niclosamide compound or a pharmaceutically acceptable salt and/or cocrystal thereof, e.g., niclosamide or a pharmaceutically acceptable salt and/or cocrystal thereof as described herein (e.g., a niclosamide compound, such as niclosamide, having a reduced particle size (e.g., having a reduced particle size range, having a reduced particle size distribution).
  • the niclosamide compound, such as niclosamide has or further has a high chemical purity as described herein.
  • methods for treating colitis (or one or more symptoms thereof) in a subject include administering to the subject an effective amount of a niclosamide compound or a pharmaceutically acceptable salt and/or cocrystal thereof, e.g., niclosamide or a pharmaceutically acceptable salt and/or cocrystal thereof as described herein (e.g., a niclosamide compound, such as niclosamide, having a reduced particle size (e.g., having a reduced particle size range, having a reduced particle size distribution).
  • the niclosamide compound, such as niclosamide has or further has a high chemical purity as described herein.
  • Embodiments can include one or more of the following features.
  • the niclosamide compound such as niclosamide, can be administered orally.
  • the subject can be a human.
  • the condition can be associated with unregulated (such as abnormal or elevated) recruitment and/or retention of one or more T cells at the gastrointestinal tract (GI) of the subject.
  • unregulated such as abnormal or elevated
  • the condition can be associated with unregulated (such as abnormal or elevated) activation of one or more T cells in the gastrointestinal tract (GI) of the subject.
  • GI gastrointestinal tract
  • the condition can be colitis.
  • the condition can be an autoimmune colitis; the condition can be an inflammatory bowel disease (e.g., ulcerative colitis or Crohn's disease).
  • the condition can be iatrogenic autoimmune colitis.
  • the condition can be colitis (e.g., iatrogenic autoimmune colitis) induced by one or more chemotherapeutic agents.
  • colitis e.g., iatrogenic autoimmune colitis
  • At least one of the one or more chemotherapeutic agents can be a chemotherapeutic immunomodulator such as an immune checkpoint inhibitor.
  • the immune checkpoint inhibitor can be an inhibitor that targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1-PD-L1, PD-1-PD-L2, interleukin-2 (IL-2), indoleamine 2,3-dioxygenase (IDO), IL-10, transforming growth factor- ⁇ (TGF ⁇ ), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9-TIM3, Phosphatidylserine-TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II-LAG3, 4-1BB-4-1BB ligand, OX40-OX40 ligand, GITR, GITR ligand-GITR, CD27, CD70-CD27, TNFRSF25, TNFRSF25-TL1A, CD40
  • the immune checkpoint inhibitor can be selected from the group consisting of: Urelumab, PF-05082566, MEDI6469, TRX518, Varlilumab, CP-870893, Pembrolizumab (PD1), Nivolumab (PD1), Atezolizumab (formerly MPDL3280A) (PDL1), MEDI4736 (PD-L1), Avelumab (PD-L1), PDR001 (PD1), BMS-986016, MGA271, Lirilumab, IPH2201, Emactuzumab, INCB024360, Galunisertib, Ulocuplumab, BKT140, Bavituximab, CC-90002, Bevacizumab, and MNRP1685A, and MGA271.
  • the immune checkpoint inhibitor can be an inhibitor that targets CTLA-4.
  • the immune checkpoint inhibitor can be an antibody.
  • the antibody can be is ipilimumab or tremelimumab.
  • the immune checkpoint inhibitor can be an inhibitor that targets PD1 or PD-L1.
  • the immune checkpoint inhibitor can be selected from nivolumab, lambroizumab, and BMS-936559.
  • the condition can be selected from the group consisting of celiac disease, irritable bowel syndrome, mucositis, uveitis, radiation enteritis, rheumatoid arthritis, lupus, scleroderma, psoriasis, cutaneous T-cell lymphoma, acute graft vs. host disease and chronic graft vs. host disease.
  • the methods can further include administering one or more additional therapeutic agents.
  • therapeutic agents useful for treating or preventing inflammatory bowel disease e.g., Crohn's disease, ulcerative colitis
  • IBD inflammatory bowel disease
  • SIP sphingosine 1-phosphate
  • steroidal anti-inflammatory agents e.g., beclomethasone 17 or budesonide
  • non-steroidal anti-inflammatory agents e.g., 5-ASA
  • receptor-interacting protein kinase 1 (RIPK1) inhibitors e.g., GSK2982772)
  • EP4 modulators e.g., KAG-308
  • toll-like receptor e.g., TLR4, TLR9 modulators
  • JKB-122, cobitolimod Janus kinase (JAK) inhibitors
  • JKB-122, cobitolimod Janus kinase (JAK) inhibitors
  • JKB-122, cobitolimod Janus kinase (JAK) inhibitors
  • JKB-122, cobitolimod Janus kinase
  • the one or more therapeutic agents can be: budenoside; epidermal growth factor; corticosteroids; cyclosporine; sulfasalazine; aminosalicylates; 6-mercaptopurine; azathioprine; metronidazole; lipoxygenase inhibitors; mesalamine; olsalazine; balsalazide; antioxidants; thromboxane inhibitors; IL-1 receptor antagonists; anti-IL-1 monoclonal antibodies; anti-IL-6 monoclonal antibodies (e.g., anti-IL-6 receptor antibodies and anti-IL-6 antibodies); growth factors; elastase inhibitors; pyridinyl-imidazole compounds; TNF antagonists as described herein; IL-4, IL-10, IL-13 and/or TGF.beta.
  • cytokines or agonists thereof e.g., agonist antibodies
  • IL-11 glucuronide- or dextran-conjugated prodrugs of prednisolone, dexamethasone or budesonide
  • ICAM-1 antisense phosphorothioate oligodeoxynucleotides ISIS 2302; Isis Pharmaceuticals, Inc.
  • soluble complement receptor 1 TP10; T Cell Sciences, Inc.
  • slow-release mesalazine methotrexate
  • antagonists of platelet activating factor (PAF) ciprofloxacin; and/or lignocaine.
  • PAF platelet activating factor
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating autoimmune colitis.
  • corticosteroids e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate
  • diphenoxylate/atropine e.g., infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating iatrogenic autoimmune colitis.
  • Non-limiting examples include corticosteroids (e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating colitis induced by one or more chemotherapeutics agents.
  • chemotherapeutics agents include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating colitis induced by treatment with adoptive cell therapy.
  • Non-limiting examples include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating colitis associated with one or more alloimmune diseases.
  • Non-limiting examples include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), sulfasalazine, and eicopentaenoic acid.
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating radaiation enteritis.
  • Non-limiting examples include teduglutide, amifostine, angiotensin-converting enzyme (ACE) inhibitors (e.g., benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril), probiotics, selenium supplementation, statins (e.g., atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and pitavastatin), sucralfate, and vitamin E.
  • statins e.g., atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and pitavastatin
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating collagenous colitis.
  • Non-limiting examples include 6-mercaptopurine, azathaioprine, bismuth subsalicate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • loperamide mesalamine, methotrexate, probiotics, and sulfasalazine.
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating lyphocytic colitis.
  • Non-limiting examples include 6-mercaptopurine, azathioprine, bismuth subsalicylate, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, and sulfasalazine.
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating microscopic colitis.
  • Non-limiting examples include 6-mercaptopurine, azathioprine, bismuth subsalicylate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), fecal microbial transplantation, loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • fecal microbial transplantation lop
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating UC.
  • Non-limiting examples include AbGn-168H, ABT-494, ABX464, apremilast, PF-00547659, PF-06687234, 6-mercaptopurine, adalimumab, azathioprine, bertilimumab, brazikumab (MEDI2070), cobitolimod, certolizumab pegol (Cimzia®), CP-690,550, corticosteroids (e.g., multimax budesonide, Methylprednisolone), cyclosporine, E6007, etrasimod, etrolizumab, fecal microbial transplantation, figlotinib, guselkumab, golimumab, IL-2, MU-838, infliximab, matrix metalloproteinase 9 (MMP9)
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating Crohn's Disease (CD).
  • CD Crohn's Disease
  • Non-limiting examples include adalimumab, autologous CD34-selected peripheral blood stem cells transplant, 6-mercaptopurine, azathioprine, certolizumab pegol (Cimzia®), corticosteroids (e.g., prednisone), etrolizumab, E6011, fecal microbial transplantation, figlotinib, guselkumab, infliximab, IL-2, JAK inhibitors, matrix metalloproteinase 9 (MMP 9) inhibitors (e.g., GS-5745), MEDI2070, mesalamine, methotrexate, natalizumab, ozanimod, RHB-104, rifaximin, risankizumab, SHP647, sulfasalazin
  • the one or more additional therapeutic agents can be therapeutic agents and/or regimens for treating IBDs.
  • Non-limiting examples include 6-mercaptopurine, AbGn-168H, ABX464, ABT-494, adalimumab, AJM300, alicaforsen, AMG139, anrukinzumab, apremilast, ATR-107 (PF0530900), autologous CD34-selected peripheral blood stem cells transplant, azathioprine, bertilimumab, BI 655066, BMS-936557, certolizumab pegol (Cimzia®), cobitolimod, corticosteroids (e.g., prednisone, Methylprednisolone, prednisone), CP-690,550, CT-P13, cyclosporine, DIMS0150, E6007, E6011, etrasimod, etrolizumab, fecal microbial transplantation,
  • a cocrystal which includes: (i) niclosamide compound, such as niclosamide or a pharmaceutically acceptable salt and/or hydrate thereof, and (ii) one or more pharmaceutically acceptable coformers.
  • the cocrystal has a reduced particle size as described anywhere herein.
  • the cocrystal coformers can include any coformers described herein, including second therapeutic agents as described above and anywhere herein.
  • niclosamide compound or “niclosamide compounds” include niclosamide as well as niclosamide analogs described in WO 2017/040864, which is incorporated herein by reference in its entirety.
  • the niclosamide compound is niclosamide.
  • Niclosamide refers to a compound having the following chemical structure:
  • Niclosamide is known by the IUPAC designation: 2′5-dichloro-4′ nitrosalicylanilide and by the CAS designation: CAS: 5-chloro-N-(2-chloro-4-nitrophenyl)-2-hydroxybenzamide.
  • Niclosamide has a relatively low water solubility at about from 5-8 mg/L at 20° C., is sparingly soluble in ether, ethanol and chloroform, and is soluble in acetone. The ethanolamine salt dissolves in distilled water 180-280 mg/L at 20° C.
  • Niclosamide is available in a various salt or solvated forms. These include, but are not limited to, the ethanolamine salt known by the IJPAC designation 5-chloro-salicyl-(2-chloro-4-nitro) anilide 2-aminoethanol salt or the CAS designation 5-chlor-N-(2-chloro-4-nitrophenyl)-2-hydroxybenzamide with 2-aminoethanol (1:1)—see, e.g., US 2013/0231312; the piperazine salt known by the PC designation 5-chloro-salicyl-(2-chloro-4-nitro) anilide piperazine salt or the CAS designation 5-chloro-N-(2-chloro-4-nitrophenyl)-2-hydroxybenzamide with piperazine (2:1); and niclosamide monohydrate known by the IUPAC designation 5-chloro-salicyl-(2-chloro-4-nitro) anilide monohydrate or the CAS designation 5-chloro-N-2-chloro-4-nitrophenyl)-2
  • Niclosamide is commercially available in a variety of formulations including, but not limited to BAYER 73®, BAYER 2353®, BAYER 25 648′, BAYUSCID®, BAYLUSCIDE®, CESTOCID®, CLONITRALID, DICHLOSALE®, FENASAL®, HL 2447®, IOMESAN®, IOMEZAN®, IINTEX®, MANOSIL®, NASEMO®, NRCLOSAMID®, PIENASAL®, TREDEMINE®, SULQUI®, VERMITID®, VERMITIN®, YOMESAN®, and the like.
  • digestive tract is understood to include the mouth, pharynx, esophagus, stomach, small intestine (duodenum, jejunum, ileum), large intestine (cecum, colon, rectum) and anus.
  • oral cavity is understood to include the mouth, the pharynx and the esophagus.
  • GI tract is understood to include the stomach, small intestine (duodenum, jejunum, ileum), large intestine (cecum, colon, rectum) and anus.
  • API refers to an active pharmaceutical ingredient (e.g., niclosamide compound, e.g., niclosamide).
  • ⁇ ективное amount refers to a sufficient amount of a chemical entity (e.g., a compound exhibiting activity as a mitochondrial uncoupling agent or a pharmaceutically acceptable salt and/or hydrate and/or cocrystal thereof; e.g., a compound, such as niclosamide or a pharmaceutically acceptable salt and/or hydrate and/or cocrystal thereof; e.g., a compound, such as a niclosamide analog, or a pharmaceutically acceptable salt and/or hydrate and/or cocrystal thereof) being administered which will relieve to some extent one or more of the symptoms of the disease or condition being treated.
  • a chemical entity e.g., a compound exhibiting activity as a mitochondrial uncoupling agent or a pharmaceutically acceptable salt and/or hydrate and/or cocrystal thereof; e.g., a compound, such as niclosamide or a pharmaceutically acceptable salt and/or hydrate and/or cocrystal thereof; e.g.,
  • an “effective amount” for therapeutic uses is the amount of the composition comprising a compound as disclosed herein required to provide a clinically significant decrease in disease symptoms.
  • An appropriate “effective” amount in any individual case is determined using any suitable technique, such as a dose escalation study.
  • excipient or “pharmaceutically acceptable excipient” means a pharmaceutically-acceptable material, composition, or vehicle, such as a liquid or solid filler, diluent, carrier, solvent, or encapsulating material.
  • each component is “pharmaceutically acceptable” in the sense of being compatible with the other ingredients of a pharmaceutical formulation, and suitable for use in contact with the tissue or organ of humans and animals without excessive toxicity, irritation, allergic response, immunogenicity, or other problems or complications, commensurate with a reasonable benefit/risk ratio.
  • pharmaceutically acceptable salt refers to a formulation of a compound that does not cause significant irritation to an organism to which it is administered and does not abrogate the biological activity and properties of the compound.
  • pharmaceutically acceptable salts are obtained by reacting a compound described herein, with acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid and the like.
  • pharmaceutically acceptable salts are obtained by reacting a compound having acidic group described herein with a base to form a salt such as an ammonium salt, an alkali metal salt, such as a sodium or a potassium salt, an alkaline earth metal salt, such as a calcium or a magnesium salt, a salt of organic bases such as dicyclohexylamine, N-methyl-D-glucamine, tris(hydroxymethyl)methylamine, and salts with amino acids such as arginine, lysine, and the like, or by other methods previously determined.
  • a salt such as an ammonium salt, an alkali metal salt, such as a sodium or a potassium salt, an alkaline earth metal salt, such as a calcium or a magnesium salt, a salt of organic bases such as dicyclohexylamine, N-methyl-D-glucamine, tris(hydroxymethyl)methylamine, and salts with amino acids such as arginine, lysine, and the like, or by other methods previously determined.
  • Examples of a salt that the compounds described hereinform with a base include the following: salts thereof with inorganic bases such as sodium, potassium, magnesium, calcium, and aluminum; salts thereof with organic bases such as methylamine, ethylamine and ethanolamine; salts thereof with basic amino acids such as lysine and ornithine; and ammonium salt.
  • the salts may be acid addition salts, which are specifically exemplified by acid addition salts with the following: mineral acids such as hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, nitric acid, and phosphoric acid:organic acids such as formic acid, acetic acid, propionic acid, oxalic acid, malonic acid, succinic acid, fumaric acid, maleic acid, lactic acid, malic acid, tartaric acid, citric acid, methanesulfonic acid, and ethanesulfonic acid; acidic amino acids such as aspartic acid and glutamic acid.
  • mineral acids such as hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, nitric acid, and phosphoric acid
  • organic acids such as formic acid, acetic acid, propionic acid, oxalic acid, malonic acid, succinic acid, fumaric acid, maleic acid, lactic acid, malic acid, tart
  • composition refers to a mixture of a compound described herein with other chemical components (referred to collectively herein as “excipients”), such as carriers, stabilizers, diluents, dispersing agents, suspending agents, and/or thickening agents.
  • excipients such as carriers, stabilizers, diluents, dispersing agents, suspending agents, and/or thickening agents.
  • the pharmaceutical composition facilitates administration of the compound to an organism. Multiple techniques of administering a compound exist in the art including, but not limited to: rectal, oral, intravenous, aerosol, parenteral, ophthalmic, pulmonary, and topical administration.
  • subject refers to an animal, including, but not limited to, a primate (e.g., human), monkey, cow, pig, sheep, goat, horse, dog, cat, rabbit, rat, or mouse.
  • primate e.g., human
  • monkey cow, pig, sheep, goat
  • horse dog, cat, rabbit, rat
  • patient are used interchangeably herein in reference, for example, to a mammalian subject, such as a human.
  • treat in the context of treating a disease or disorder, are meant to include alleviating or abrogating a disorder, disease, or condition, or one or more of the symptoms associated with the disorder, disease, or condition; or to slowing the progression, spread or worsening of a disease, disorder or condition or of one or more symptoms thereof.
  • beneficial effects that a subject derives from a therapeutic agent do not result in a complete cure of the disease, disorder or condition.
  • niclosamide compounds or pharmaceutically acceptable salts and/or cocrystals thereof, e.g., niclosamide or pharmaceutically acceptable salt and/or cocrystal thereof), having one or more properties that include, but are not limited to: a particular purity (e.g., a chemical purity of greater than about 99.0%) and a particular particle size (e.g., a particular particle size distribution and/or a particular particle size range and/or a specific surface area range).
  • the niclosamide compounds described herein e.g., niclosamide
  • niclosamide compounds e.g., niclosamide
  • administration e.g., oral administration
  • niclosamide compounds e.g., niclosamide
  • GI gastrointestinal
  • inflammatory bowel disease e.g., ulcerative colitis and Crohn's disease
  • This disclosure also features methods of making and using the niclosamide compounds.
  • the niclosamide compounds (e.g., niclosamide) has a chemical purity of greater than about 99.0%; e.g., greater than about 99.5%; or greater than about 99.7%; or greater than about 99.8%.
  • the niclosamide compounds (e.g., niclosamide) have less than about 45 ppm of 5-chloro-salicylic acid; e.g., less than about 30 ppm of 5-chloro-salicylic acid.
  • the compound has less than about 50 ppm of 2-chloro-4 nitro-aniline. In certain embodiments, the compound has less than about 10 ppm of 2-chloro-4 nitro-aniline.
  • the compound has less than about 45 ppm of 5-chloro-salicylic acid and less than about 50 ppm of 2-chloro-4 nitro-aniline.
  • the compound has less than about 30 ppm of 5-chloro-salicylic acid and less than about 10 ppm of 2-chloro-4 nitro-aniline.
  • the compound has less than about 0.05% water. In certain embodiments, the compound is substantially free of hydrated niclosamide solid forms. As a non-limiting example, the compound can be anhydrous niclosamide.
  • purification can be carried out according to the following process.
  • Acetone and crude niclosamide are mixed in a vessel and heated to reflux ( ⁇ 56° C.) until solids dissolve.
  • the solution is clarified by filtration and transferred to a second vessel, heated to 45° C. to 55° C. to dissolve the solids, cooled to ⁇ 5° C. to 5° C. and stirred at this temperature for at least 2 hours.
  • the solids are filtered and washed with acetone. Crystallized niclosamide is obtained after vacuum drying of the solids at 70° C.
  • IPC LOD testing is performed on the dry solids with a specification of ⁇ 1.0%. If the LOD results are >1.0% the drying step may be repeated two additional times. IPC testing is also performed to ensure the level of the starting material 2-chloro-4-nitroaniline is ⁇ 100 ppm. If the level of 2-chloro-4-nitroaniline is >100 ppm, a second crystallization may be performed.
  • purity analysis can be achieved according to the following procedure.
  • Chromatograph UPLC system consisting pump, diode array; detector, autosampler, auto injector, and column cooler/heater, or equivalent.
  • Column Agilent Poroshell 120 EC-C18 column, 4.6 ⁇ 50 mm, 2.7 ⁇ m or equivalent. Column Temperature: 35° C.
  • Mobile phase A 20 mM ammonium acetate (pH 5.50).
  • Mobile phase B MeOH:ACN (70:30, v/v).
  • Diluent MeOH:DMSO (70:30, v/v).
  • the compound has a reduced particle size (e.g., as achieved by techniques including but not limited to milling).
  • the compound has a particle size range of from about 0.1 ⁇ m to about 30 ⁇ m. In certain embodiments, the compound has a particle size range of from about 0.1 ⁇ m to about 20 ⁇ m. In certain embodiments, the compound has a particle size range of from about 0.1 ⁇ m to about 10 ⁇ m.
  • particle size distribution of a powder, or granular material, or particles dispersed in fluid, as used within this application, is a list of values or a mathematical function that defines the relative amounts of particles present, sorted according to size.
  • the d(0.1), d(0.5) and d(0.9) values indicate that 10%, 50% and 90% of the particles measured were less than or equal to the size stated.
  • Particle Size Distribution can be determined by laser diffraction technique, e.g., using a “MALVERN MASTERSIZER 2000” (standard range between 0.020 and 2000.0 microns), model “APA 2000”, equipped with “Hydro 2000 sm” as dispersing unit.
  • a representative procedure includes: approximately 50 mg of Niclosamide is dispersed manually into 25 ml of water; after dispersion the sample was sonicated with external ultrasound for two minutes (Ultrasonic frequency; 37 kHz—Elmasonic S100 (H)—Elma Schmidbauer GmbH, Germany); the following operative conditions/machine parameters are taken into account: Dispersant: Water+3 drops of Tyloxapol 1.5%; Background measurement time: 10 seconds; Number of measurements cycles: 3 (to obtain average value); Stir speed (dispersing unit): 1500 rpm.
  • the compound has a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 15.0 ⁇ m. In certain embodiments, the compound has a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 10.0 ⁇ m. In certain embodiments, the compound has a particle size distribution D(0.9) of from about 6.0 ⁇ m to about 8.0 ⁇ m (e.g., about 7.3 ⁇ m (e.g., 7.3 ⁇ m)). In other embodiments, the compound has a particle size distribution D(0.9) of from about 2.2 ⁇ m to about 3.2 ⁇ m.
  • the compound has a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.5 ⁇ m. In certain embodiments, the compound has a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.0 ⁇ m. In certain embodiments, the compound has a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m. In certain embodiments, the compound has a particle size distribution D(0.1) of from about 0.45 ⁇ m to about 0.75 ⁇ m (e.g., about 0.6 ⁇ m (e.g., 0.6 ⁇ m)).
  • the compound has a particle size distribution D(0.5) of from about 0.5 ⁇ m to about 6.0 ⁇ m. In certain embodiments, the compound has a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m. In certain embodiments, the compound has a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 2.0 ⁇ m. In certain other embodiments, the compound has a particle size distribution D(0.5) of from about 2.5 ⁇ m to about 3.5 ⁇ m (e.g., about 3.1 ⁇ m (e.g., 3.1 ⁇ m)).
  • the parameter D(0.1) as used herein refers to the mesh size of a single notional sieve allowing 10% of the total of all particles of the sample to pass.
  • 10% of the total particles have a particle size of not more than D(0.1) meaning in this case that they have a maximum size of 0.1 ⁇ m to 1.5 ⁇ m.
  • the parameter D(0.5) refers to the mesh size of a single notional sieve allowing 50% of the total of all particles of the sample to pass.
  • 50% of the total of all particles have a particle size of not more than D(0.5) meaning in this case that they have a maximum size of 0.5 ⁇ m to 6.0 ⁇ m.
  • the parameter D(0.9) refers to the mesh size of a single notional sieve allowing 90% of the total of all particles of the sample to pass i.e. only 10% of the sample is retained.
  • 90% of all particles have a particle size of not more than D(0.9) meaning in this case that they have a maximum size of 1.0 ⁇ m to 15.0 ⁇ m.
  • the compound has less than about 0.05% water (e.g., as determined by Karl Fisher technique).
  • the compound is substantially free of hydrated niclosamide solid forms.
  • the compound can be anhydrous niclosamide.
  • the compound is crystalline.
  • the compound has a specific surface area of from about 5 m 2 /g to about 10 m 2 /g.
  • the compound has a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 10.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.0 ⁇ m.
  • the compound has a particle size distribution D(0.9) of from about 6.0 ⁇ m to about 8.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the compound has a particle size distribution D(0.9) of from about 7.0 ⁇ m to about 7.5 ⁇ m (e.g., about 7.3 ⁇ m), a particle size distribution D(0.5) of from about 2.5 ⁇ m to about 4.0 ⁇ m (e.g., about 3.1 ⁇ m), and a particle size distribution D(0.1) of from about 0.45 ⁇ m to about 0.75 ⁇ m (e.g., about 0.6 ⁇ m).
  • the compound has a particle size distribution D(0.9) of about 7.3 ⁇ m, a particle size distribution D(0.5) of about 3.1 ⁇ m, and a particle size distribution D(0.1) of about 0.6 ⁇ m.
  • the compound has a particle size distribution D(0.9) of from about 2.2 ⁇ m to about 3.2 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the compound has a chemical purity of greater than about 99.0%, a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 10.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.0 ⁇ m.
  • the compound has a chemical purity of greater than about 99.0%, a particle size distribution D(0.9) of from about 6.0 ⁇ m to about 8.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the compound has a chemical purity of greater than about 99.0%, a particle size distribution D(0.9) of from about 2.2 ⁇ m to about 3.2 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the compound has a chemical purity of greater than about 99.0%, a particle size range of from about 0.1 ⁇ m to about 30 ⁇ m, a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 10.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.0 ⁇ m.
  • the compound has a chemical purity of greater than about 99.0%, a particle size range of from about 0.1 ⁇ m to about 30 ⁇ m, a particle size distribution D(0.9) of from about 6.0 ⁇ m to about 8.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the compound has a chemical purity of greater than about 99.0%, a particle size range of from about 0.1 ⁇ m to about 30 ⁇ m, a particle size distribution D(0.9) of from about 2.2 ⁇ m to about 3.2 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the compound has a particle size distribution D(0.5) of from about 2.5 ⁇ m to about 3.5 ⁇ m.
  • the compound has a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 2.0 ⁇ m.
  • the compound has a chemical purity of greater than about 99.5%; or a chemical purity of greater than about 99.7%; or a chemical purity of greater than about 99.8%.
  • the compound has less than about 45 ppm of 5-chloro-salicylic acid; or less than about 30 ppm of 5-chloro-salicylic acid.
  • the compound has less than about 50 ppm of 2-chloro-4 nitro-aniline; or less than about 10 ppm of 2-chloro-4 nitro-aniline.
  • the compound has less than about 45 ppm of 5-chloro-salicylic acid and less than about 50 ppm of 2-chloro-4 nitro-aniline; or less than about 30 ppm of 5-chloro-salicylic acid and less than about 10 ppm of 2-chloro-4 nitro-aniline.
  • the compound has less than about 0.05% water.
  • the compound is substantially free of hydrated niclosamide solid forms.
  • the compound is anhydrous niclosamide.
  • the compound is crystalline.
  • the compound has a specific surface area of from about 5 m 2 /g to about 10 m 2 /g.
  • the niclosamide compounds can be in the form of a cocrystal that includes (i) a niclosamide compound (e.g., niclosamide) or a pharmaceutically acceptable salt thereof; and (ii) one or more pharmaceutically acceptable coformers.
  • co-crystal refers to a crystalline material comprised of two or more unique solids at room temperature in a stoichiometric or non-stoichiometric ratio, which are held together in the crystal lattice by one or more non-covalent interactions (e.g., hydrogen bonds, pi-stacking, guest-host complexation and van der Waals interactions).
  • At least one of the one or more non-covalent interactions is a hydrogen bond.
  • the chemical entity is the hydrogen bond donor, and one of one or more coformers is the hydrogen bond acceptor. In other embodiments, the chemical entity is the hydrogen bond acceptor, and one of one or more coformers is the hydrogen bond donor.
  • the co-crystals described herein can include one or more solvate (e.g., water or an organic solvent containing one or more hydroxyl groups, e.g., a C 1 -C 6 alcohol or diol, e.g., a C 1 -C 6 alcohol or diol, e.g., ethanol or propylene glycol) molecules in the crystalline lattice.
  • solvates of chemical entities that do not further comprise a coformer e.g., a solid conformer
  • the cocrystal includes more than one coformer.
  • two, three, four, five, or more co formers can be incorporated in a co-crystal with the chemical entity.
  • the ratio of the chemical entity to each of the one or more pharmaceutically acceptable coformers may be stoichiometric or non-stoichiometric. As a non-limiting example, 1:1, 1:1.5 and 1:2 ratios of chemical entity:coformer are contemplated.
  • the niclosamide compounds (e.g, niclosamide) and each of the one or more pharmaceutically acceptable coformers may each be independently specified as a free form, or more specifically, a free acid, free base, or zwitter ion; a salt, or more specifically for example, an inorganic base addition salt such as sodium, potassium, lithium, calcium, magnesium, ammonium, aluminum salts or organic base addition salts, or an inorganic acid addition salts such as HBr, HCl, sulfuric, nitric, or phosphoric acid addition salts or an organic acid addition salt such as acetic, proprionic, pyruvic, malanic, succinic, malic, maleic, fumaric, tartaric, citric, benzoic, methanesulfonic, ethanesulforic, stearic or lactic acid addition salt; an anhydrate or hydrate of a free form or salt, or more specifically, for example, a hemihydrate, monohydrate, dihydrate, trihydrate,
  • At least one of the one or more pharmaceutically acceptable coformers can form one or more hydrogen bonds with the chemical entity in the cocrystal. In some embodiments, at least one of the one or more pharmaceutically acceptable coformers can accept one or more hydrogen bonds from the chemical entity in the cocrystal. In some embodiments, at least one of the one or more pharmaceutically acceptable coformers can form one or more hydrogen bonds with the chemical entity in the cocrystal, and at least one of the one or more pharmaceutically acceptable coformers can accept one or more hydrogen bonds from the chemical entity in the cocrystal.
  • At least one of the one or more pharmaceutically acceptable coformers comprises one or more functional groups selected from the group consisting of: ether, thioether, hydroxy, sulfhydryl, aldehyde, ketone, thioketone, nitrate ester, phosphate ester, thiophosphate ester, ester, thioester, sulfate ester, carboxylic acid, phosphonic acid, phosphinic acid, sulfonic acid, amido, primary amine, secondary amine, ammonia, tertiary amino, sp2 amino, thiocyanate, cyanamide, oxime, nitrile, diazo, haloalkyl, nitro, heterocyclic ring, heteroaryl ring, epoxide, peroxide, and hydroxamic acid.
  • functional groups selected from the group consisting of: ether, thioether, hydroxy, sulfhydryl, aldehyde, ketone
  • each of the one of the one or more pharmaceutically acceptable coformers is independently selected from acetamide, benzamide, (+/ ⁇ )-limonene, 1-(phenylazo)-2-naphthylamine, 1,2,6-hexanetriol, 1,2-dimyristoyl-sn-glycero-3-(phospho-s-(1-glycerol)), 1,2-dimyristoyl-sn-glycero-3-phosphocholine, 1,2-dioleoyl-sn-glycero-3-phosphocholine, 1,2-dipalmitoyl-sn-glycero-3-(phospho-rac-(1-glycerol)), 1,2-distearoyl-sn-glycero-3-(phospho-rac-(1-glycerol)), 1,2-distearoyl-sn-glycero-3-phosphocholine, 1,5-naphthalene-disulfonic acid, 1-hydroxy-2-na
  • At least one of the one or more pharmaceutically acceptable coformers is selected from the group consisting of caffeine, urea, p-aminobenzoic acid, theophylline, benzyl benzoate, and nicotinamide.
  • the one or more pharmaceutically acceptable coformers is other than those selected from the group consisting of caffeine, urea, p-aminobenzoic acid, theophylline, benzyl benzoate, and nicotinamide.
  • the one or more pharmaceutically acceptable coformers is other than those selected from the group consisting of acetamide, benzamide, 2-aminothiazole, and isoniazide.
  • the one or more pharmaceutically acceptable coformers is an amino acid (e.g., proline, e.g., D-proline or L-proline, or racemic proline).
  • the one or more pharmaceutically acceptable coformers is a 5-10 (e.g., 5-9, 5-6, or 5) membered heteroaryl, e.g., a nitrogen-containing heteroaryl, e.g., imidazole.
  • At least one of the one or more pharmaceutically acceptable coformers is a second API.
  • the second API is independently selected from ( ⁇ )-amlodipine, ( ⁇ )-halofenate, (R)-salbutamol, (R)-salbutamol, (R,R)-formoterol, (S)-doxazosin, (S)-fluoxetine, (S)-oxybutynin, 1,2-naphthoquinone, 17-methyltestosterone, 17 ⁇ -hydroxyprogesterone, 195mPt-cisplatin, 1-naphthyl salicylate, 1-naphthylamine-4-, 1-theobromineacetic, 1 ⁇ -hydroxycholecalciferol, 2,4,6-tribromo-m-cresol, 2,6-diamino-2′-butyloxy-3,5′-azopyridine, 2-[[[[(1r)-2-(1h-imidazol-4
  • pharmaprojects no. 4994 pharmaprojects no. 5325, pharmaprojects no. 5972, pharmaprojects no. 6446, pharmaprojects no. 6590, pharmaprojects no. 6656, pharmaprojects no. 6691, pharmaprojects no. 6743, pharmaprojects no.
  • phenacaine phenacemide, phenacetin, phenadoxone, phenallymal, phenamet, phenamide, phenazocine, phenazopyridine, phenbutamide, phencyclidine, phendimetrazine, phenelzine, phenesterine, phenetharbital, phenethicillin, pheneturide, phenformin, phenglutarimide, phenindamine, phenindione, pheniprazine, pheniramine, phenmetrazine, phenobarbital, phenobutiodil, phenocoll, phenoctide, phenolphthalein, phenolphthalol, phenolsulfonphthalein, phenol-tetrachlorophthalein, phenoperidine, phenosulfazole, phenoxybenzamine, phenoxypropazine, phenprobamate, phenprocoumon, phenserine, phenallymal,
  • At least one of the one or more pharmaceutically acceptable coformers can be a compound having any one of formulas (I), (XVIII)-(XXV), and XXVII, (e.g., formula XXIV or XXV) as described in U.S. Pat. No. 10,292,951 which is incorporated herein by reference in its entirety; or any one of the compounds delineated above.
  • At least one of the one or more pharmaceutically acceptable coformers can be a niclosamide analogue having any one of formulas (I), (XVIII)-(XXV), and XXVII (e.g., formula XXIV or XXV; or XXVI) as described in U.S. Pat. No. 10,292,951 which is incorporated herein by reference in its entirety; or any one of the compounds specifically delineated above.
  • the coformer can be any one or more additional therapeutic agents as described herein.
  • the co-former is selected from the group consisting of: a sphingosine 1-phosphate (SiP) receptor modulator; a steroidal anti-inflammatory agent; a non-steroidal anti-inflammatory agent; a receptor-interacting protein kinase 1 (RIPK1) inhibitor; an EP4 modulator; a toll-like receptor (e.g., TLR4, TLR9) modulator; a Janus kinase (JAK) inhibitor; a lanthionine synthetase C-like 2 (LANCL2) modulator; a phosphatidylcholine; an integrin (e.g., a4 Integrin) modulator; a Smad7 modulator; a phosphodiesterase 4 (PDE4) modulator; a tumor progression locus 2 (TPL2) inhibitor; a tyrosine kinase 2 (TYK2) inhibitor; and a TEC kinase inhibitor.
  • SiP sphingosine 1-phosphate
  • the co-former is a sphingosine 1-phosphate (SiP) receptor modulator.
  • the co-former is etrasimod or ozanimod.
  • the co-former is a steroidal anti-inflammatory agent.
  • the co-former can be beclomethasone 17 or budesonide.
  • the co-former is a non-steroidal anti-inflammatory agent such as 5-ASA.
  • the co-former is a receptor-interacting protein kinase 1 (RIPK1) inhibitor such as GSK2982772.
  • RIPK1 receptor-interacting protein kinase 1
  • the co-former is an EP4 modulator such as KAG-308.
  • the co-former is a toll-like receptor (e.g., TLR4, TLR9) modulator.
  • the co-former is a TLR4 modulator such as JKB-122.
  • the co-former is a TLR9 modulator such as cobitolimod.
  • the co-former is a Janus kinase (JAK) inhibitor.
  • the co-former is selected from the group consisting of TD-1473, tofacitinib, upadacitinib, filgotinib, PF-06651600, and PF-06700841.
  • the co-former is a lanthionine synthetase C-like 2 (LANCL2) modulator such as BT-11.
  • LANCL2 lanthionine synthetase C-like 2
  • the co-former is a phosphatidylcholine such as LT-02.
  • the co-former is an integrin modulator.
  • the co-former is an ⁇ 4 Integrin modulator such as AJM-300 (carotegrast).
  • the co-former is a Smad7 antisense oligonucleotide such as mongersen.
  • the co-former is a phosphodiesterase 4 (PDE4) modulator such as apremilast.
  • PDE4 phosphodiesterase 4
  • the co-former is a tumor progression locus 2 (TPL2) inhibitor such as GS-4875.
  • TPL2 tumor progression locus 2
  • the co-former is a tyrosine kinase 2 (TYK2) inhibitor.
  • the co-former is BMS-986165, PF-06700841, or PF-06826647.
  • the co-former is a TEC kinase inhibitor such as PF-06651600.
  • the cocrystal includes (i) niclosamide; and (ii) a pharmaceutically acceptable salt of niclosamide; or a pharmaceutically acceptable salt and/or hydrate of niclosamide of a niclosamide analog.
  • the cocrystal includes (i) niclosamide; and (ii) a second API.
  • the cocrystal includes (i) a pharmaceutically acceptable salt of niclosamide; and (ii) a second API.
  • the cocrystal includes (i) niclosamide; and (ii) a second API.
  • the cocrystal includes (i) a pharmaceutically acceptable salt of niclosamide; and (ii) an amino acid (e.g., proline, e.g., D-proline, or L-proline, or racemic proline).
  • an amino acid e.g., proline, e.g., D-proline, or L-proline, or racemic proline.
  • the cocrystal includes (i) niclosamide; and (ii) an amino acid (e.g., proline, e.g., D-proline, or L-proline, or racemic proline).
  • an amino acid e.g., proline, e.g., D-proline, or L-proline, or racemic proline.
  • the cocrystal includes (i) a pharmaceutically acceptable salt of niclosamide; and (ii) a 5-10 (e.g., 5-9, 5-6, or 5) membered heteroaryl, e.g., a nitrogen-containing heteroaryl, e.g., imidazole.
  • a pharmaceutically acceptable salt of niclosamide e.g., 5-9, 5-6, or 5
  • a 5-10 e.g., 5-9, 5-6, or 5
  • membered heteroaryl e.g., a nitrogen-containing heteroaryl, e.g., imidazole.
  • the cocrystal includes (i) niclosamide; and (ii) a 5-10 (e.g., 5-9, 5-6, or 5) membered heteroaryl, e.g., a nitrogen-containing heteroaryl, e.g., imidazole.
  • a 5-10 e.g., 5-9, 5-6, or 5
  • membered heteroaryl e.g., a nitrogen-containing heteroaryl, e.g., imidazole.
  • the chemical purity of the niclosamide compound can be as defined anywhere herein.
  • the co-crystal can have a reduced particle size as defined anywhere herein for the niclosamide compounds.
  • co-crystals having reduced particle size can be prepared by jet milling, e.g., using CMTI equipment NGMP-Mill-A, a 2-inch, pancake micronizer manufactured by Sturtevant.
  • Particle Size Distribution can be determined by laser diffraction technique, e.g., using a “MALVERN MASTERSIZER 2000” (standard range between 0.020 and 2000.0 microns), model “APA 2000”, equipped with “Hydro 2000 sm” as dispersing unit.
  • the co-crystal has a reduced particle size range.
  • co-crystal has a particle size range of from about 0.1 ⁇ m to about 30 ⁇ m. In certain embodiments, the co-crystal has a particle size range of from about 0.1 ⁇ m to about 20 ⁇ m. In certain embodiments, the co-crystal has a particle size range of from about 0.1 ⁇ m to about 10 ⁇ m.
  • the co-crystal has a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 15.0 ⁇ m. In certain embodiments, the co-crystal has a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 10.0 ⁇ m. In certain embodiments, the co-crystal has a particle size distribution D(0.9) of from about 6.0 ⁇ m to about 8.0 ⁇ m. In certain embodiments, the co-crystal has a particle size distribution D(0.9) of from about 2.2 ⁇ m to about 3.2 ⁇ m.
  • the co-crystal has a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.5 ⁇ m. In certain embodiments, the co-crystal has a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.0 ⁇ m. In certain embodiments, the co-crystal has a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the co-crystal has a particle size distribution D(0.5) of from about 0.5 ⁇ m to about 6.0 ⁇ m. In certain embodiments, the co-crystal has a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m. In certain embodiments, the co-crystal has a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 2.0 ⁇ m. In certain embodiments, the co-crystal has a particle size distribution D(0.5) of from about 2.5 ⁇ m to about 3.5 ⁇ m.
  • the co-crystal has a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 10.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.0 ⁇ m.
  • the co-crystal has a particle size distribution D(0.9) of from about 6.0 ⁇ m to about 8.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the co-crystal has a particle size distribution D(0.9) of from about 2.2 ⁇ m to about 3.2 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the niclosamide compound has a chemical purity of greater than about 99.0%; and the co-crystal has a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 10.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.0 ⁇ m.
  • the niclosamide compound has a chemical purity of greater than about 99.0%; and the co-crystal has a particle size distribution D(0.9) of from about 6.0 ⁇ m to about 8.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the niclosamide compound has a chemical purity of greater than about 99.0%; and the co-crystal has a particle size distribution D(0.9) of from about 2.2 ⁇ m to about 3.2 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the niclosamide compound has a chemical purity of greater than about 99.0%; and the co-crystal has a particle size range of from about 0.1 ⁇ m to about 30 ⁇ m, a particle size distribution D(0.9) of from about 1.0 ⁇ m to about 10.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.1 ⁇ m to about 1.0 ⁇ m.
  • the niclosamide compound has a chemical purity of greater than about 99.0%; and the co-crystal has a particle size range of from about 0.1 ⁇ m to about 30 ⁇ m, a particle size distribution D(0.9) of from about 6.0 ⁇ m to about 8.0 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the niclosamide compound has a chemical purity of greater than about 99.0%; and the co-crystal has a particle size range of from about 0.1 ⁇ m to about 30 ⁇ m, a particle size distribution D(0.9) of from about 2.2 ⁇ m to about 3.2 ⁇ m, a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 4.0 ⁇ m, and a particle size distribution D(0.1) of from about 0.3 ⁇ m to about 0.9 ⁇ m.
  • the co-crystal has a particle size distribution D(0.5) of from about 2.5 ⁇ m to about 3.5 ⁇ m.
  • the co-crystal has a particle size distribution D(0.5) of from about 1.0 ⁇ m to about 2.0 ⁇ m.
  • a niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof is administered to a subject in need thereof by any route which makes the compound bioavailable (e.g., locally bioavailable).
  • the route is oral administration.
  • a niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof is administered as a pharmaceutical composition that includes the chemical entity and one or more pharmaceutically acceptable excipients, and optionally one or more other therapeutic agents as described herein.
  • the niclosamide compounds can be administered in combination with one or more conventional pharmaceutical excipients.
  • Pharmaceutically acceptable excipients include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, self-emulsifying drug delivery systems (SEDDS) such as d- ⁇ -tocopherol polyethylene glycol 1000 succinate, surfactants used in pharmaceutical dosage forms such as Tweens, poloxamers or other similar polymeric delivery matrices, serum proteins, such as human serum albumin, buffer substances such as phosphates, tris, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium-chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol
  • Cyclodextrins such as ⁇ -, ⁇ , and ⁇ -cyclodextrin, or chemically modified derivatives such as hydroxyalkylcyclodextrins, including 2- and 3-hydroxypropyl-o-cyclodextrins, or other solubilized derivatives can also be used to enhance delivery of compounds described herein.
  • Dosage forms or compositions containing a chemical entity as described herein in the range of 0.005% to 100% with the balance made up from non-toxic excipient may be prepared.
  • the contemplated compositions may contain 0.001%-100% of a chemical entity provided herein, in one embodiment 0.1-95%, in another embodiment 75-85%, in a further embodiment 20-80%.
  • Actual methods of preparing such dosage forms are known, or will be apparent, to those skilled in this art; for example, see Remington: The Science and Practice of Pharmacy, 22 nd Edition (Pharmaceutical Press, London, U K. 2012).
  • the niclosamide compounds described herein or a pharmaceutical composition thereof can be administered to subject in need thereof by any accepted route of administration.
  • Acceptable routes of administration include, but are not limited to, buccal, cutaneous, endocervical, endosinusial, endotracheal, enteral, epidural, interstitial, intra-abdominal, intra-arterial, intrabronchial, intrabursal, intracerebral, intracisternal, intracoronary, intradermal, intraductal, intraduodenal, intradural, intraepidermal, intraesophageal, intragastric, intragingival, intraileal, intralymphatic, intramedullary, intrameningeal, intramuscular, intraovarian, intraperitoneal, intraprostatic, intrapulmonary, intrasinal, intraspinal, intrasynovial, intratesticular, intrathecal, intratubular, intratumor, intrauterine, intravascular, intravenous, nasal, nas
  • the niclosamide compounds described herein or a pharmaceutical composition thereof are suitable for local administration, e.g., local administration by way of administering the niclosamide compounds or composition thereof at a particular treatment site, (e.g., the digestive tract, the gastrointestinal (“GI”) tract, e.g., colon) so as to provide local administration of the chemical entity to the area in need of treatment (e.g., oral cavity; GI tract, e.g., the colon; eye; skin; or joint).
  • GI gastrointestinal
  • relatively low systemic exposure of the niclosamide compounds occurs during said local administration.
  • compositions include, e.g., oral administration.
  • the niclosamide compounds described herein or a pharmaceutical composition thereof are suitable for local administration to the GI tract, e.g., colon.
  • the local concentration of the niclosamide compounds in the GI tract is higher (e.g., from about 2 times higher to about 1,000 times higher; from about 2 times higher to about 900 times higher; from about 2 times higher to about 800 times higher; from about 2 times higher to about 700 times higher; from about 2 times higher to about 500 times higher; from about 2 times higher to about 400 times higher; from about 2 times higher to about 300 times higher; from about 2 times higher to about 200 times higher; from about 2 times higher to about 100 times higher; from about 2 times higher to about 50 times higher, from about 5 times higher to about 1,000 times higher; from about 5 times higher to about 900 times higher; from about 5 times higher to about 800 times higher; from about 2 times higher to about 700 times higher; from about 5 times higher to about 500 times higher; from about 5 times higher to about 400 times higher; from about 5 times higher to about
  • the niclosamide compounds described herein or a pharmaceutical composition thereof are suitable for local administration to one or more specific locations within the digestive or GI tract, e.g., colon.
  • the niclosamide compound is present in the upper GI tract (e.g., stomach); or at least some of the niclosamide compound is present in the lower GI tract (e.g., the large intestine, e.g., the colon, e.g., the ascending colon and/or transverse colon and/or distal colon; or the small bowel).
  • niclosamide compound is present in the ascending colon and/or the transverse colon and/or the distal colon and/or the small bowel and/or the stomach.
  • Methods of said local administration can include, without limitation, oral administration.
  • composition comprising a niclosamide compound or co-crystal as described anywhere herein and one or more pharmaceutically acceptable excipients, wherein the composition is suitable for oral administration.
  • administration of a single dose of the composition to a subject produces a local concentration of the niclosamide compound in the GI tract (e.g., colon) of the subject that is higher than the concentration of the compound in the plasma compartment of the subject.
  • administration of a single dose of the composition to a subject produces a local concentration of the niclosamide compound in the GI tract (e.g., colon) of the subject that is at least about 200 times higher than the concentration of the compound in the plasma compartment of the subject.
  • administration of a single dose of the composition to a subject produces a local concentration of the niclosamide compound in the GI tract (e.g., colon) of the subject that is at least about 300 times higher than the concentration of the compound in the plasma compartment of the subject.
  • administration of a single dose of the composition to a subject produces a local concentration of the niclosamide compound in the GI tract (e.g., colon) of the subject that is at least about 500 times higher than the concentration of the compound in the plasma compartment of the subject.
  • administration of a single dose of the composition to a subject produces a local concentration of the niclosamide compound in the GI tract (e.g., colon) of the subject that is at least about 700 times higher than the concentration of the compound in the plasma compartment of the subject.
  • the local concentration of the niclosamide compound in the GI tract (e.g., colon) of the subject is higher than a local concentration produced by oral administration of a single dose of a second composition comprising a second niclosamide compound, wherein the second niclosamide compound has a higher particle size than the niclosamide compound.
  • the local concentration of the niclosamide compound in the GI tract (e.g., colon) of the subject is at least about 100 times higher than a local concentration produced by oral administration of a single dose of a second composition comprising a second niclosamide compound, wherein the second niclosamide compound has a higher particle size than the niclosamide compound.
  • the local concentration of the niclosamide compound in the GI tract (e.g., colon) of the subject is at least about 100 times higher than a local concentration produced by oral administration of a single dose of a second composition comprising a second niclosamide compound, wherein the second niclosamide compound has a higher particle size than the niclosamide compound.
  • the second niclosamide compound has a particle size distribution D(0.9) of from about 25.0 ⁇ m to about 65.0 ⁇ m.
  • the second niclosamide compound has a particle size distribution D(0.1) of from about 4.0 ⁇ m to about 10.0 ⁇ m.
  • a dosage form e.g., a unit dosage form
  • a composition as described anywhere herein wherein the dosage form is suitable for oral administration.
  • the dosage form further comprises one or more components that chemically and/or structurally predispose the dosage form for delivery of the compound to the ascending colon.
  • the dosage form further comprises one or more components that chemically and/or structurally predispose the dosage form for delivery of the compound to the transverse colon.
  • the dosage form further comprises one or more components that chemically and/or structurally predispose the dosage form for delivery of the compound to the distal colon.
  • the dosage form further comprises one or more components that chemically and/or structurally predispose the dosage form for delivery of the compound to the small bowel.
  • the chemical entities described herein or a pharmaceutical composition thereof are suitable for local delivery to the digestive or GI tract by way of oral administration (e.g., solid or liquid dosage forms.).
  • Solid dosage forms for oral administration include capsules, tablets, pills, powders, and granules.
  • the chemical entity is mixed with one or more pharmaceutically acceptable excipients, such as sodium citrate or dicalcium phosphate and/or: a) fillers or extenders such as starches, lactose, sucrose, glucose, mannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, e) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cetyl alcohol and glycerol mono
  • the dosage form may also comprise buffering agents.
  • Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like.
  • the compositions will take the form of a unit dosage form such as a pill or tablet and thus the composition may contain, along with a chemical entity provided herein, a diluent such as lactose, sucrose, dicalcium phosphate, or the like; a lubricant such as magnesium stearate or the like; and a binder such as starch, gum acacia, polyvinylpyrrolidine, gelatin, cellulose, cellulose derivatives or the like.
  • a diluent such as lactose, sucrose, dicalcium phosphate, or the like
  • a lubricant such as magnesium stearate or the like
  • a binder such as starch, gum acacia, polyvinylpyrrolidine, gelatin, cellulose, cellulose derivatives or the like.
  • a powder, marume, solution or suspension (e.g., in propylene carbonate, vegetable oils, PEG's, poloxamer 124 or triglycerides) is encapsulated in a capsule (gelatin or cellulose base capsule).
  • Unit dosage forms in which one or more chemical entities provided herein or additional active agents are physically separated are also contemplated; e.g., capsules with granules (or tablets in a capsule) of each drug; two-layer tablets; two-compartment gel caps, etc. Enteric coated or delayed release oral dosage forms are also contemplated.
  • physiologically acceptable compounds include wetting agents, emulsifying agents, dispersing agents or preservatives that are particularly useful for preventing the growth or action of microorganisms.
  • Various preservatives are well known and include, for example, phenol and ascorbic acid.
  • the excipients are sterile and generally free of undesirable matter. These compositions can be sterilized by conventional, well-known sterilization techniques. For various oral dosage form excipients such as tablets and capsules sterility is not required. The USP/NF standard is usually sufficient.
  • solid oral dosage forms can further include one or more components that chemically and/or structurally predispose the composition for delivery of the chemical entity to the stomach or the lower GI; e.g., the ascending colon and/or transverse colon and/or distal colon and/or small bowel.
  • Exemplary formulation techniques are described in, e.g., Filipski, K. J., et al., Current Topics in Medicinal Chemistry, 2013, 13, 776-802, which is incorporated herein by reference in its entirety.
  • Examples include upper-GI targeting techniques, e.g., Accordion Pill (Intec Pharma), floating capsules, and materials capable of adhering to mucosal walls.
  • Upper-GI targeting techniques e.g., Accordion Pill (Intec Pharma)
  • floating capsules e.g., floating capsules, and materials capable of adhering to mucosal walls.
  • enteric/pH-responsive coatings and excipients are available. These materials are typically polymers that are designed to dissolve or erode at specific pH ranges, selected based upon the GI region of desired drug release. These materials also function to protect acid labile drugs from gastric fluid or limit exposure in cases where the active ingredient may be irritating to the upper GI (e.g., hydroxypropyl methylcellulose phthalate series, Coateric (polyvinyl acetate phthalate), cellulose acetate phthalate, hydroxypropyl methylcellulose acetate succinate, Eudragit series (methacrylic acid-methyl methacrylate copolymers), and Marcoat).
  • Other techniques include dosage forms that respond to local flora in the GI tract, Pressure-controlled colon delivery capsule, and Pulsincap.
  • Liquid dosage forms for oral administration include pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups and elixirs.
  • the liquid dosage forms may contain inert diluents commonly used in the art such as, for example, water or other solvents, solubilizing agents and emulsifiers such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, dimethylformamide, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor, and sesame oils), glycerol, tetrahydrofurfuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof.
  • inert diluents commonly used in the art such as, for example, water or other solvents, solubilizing agents and
  • the oral compositions can also include adjuvants such as wetting agents, emulsifying and suspending agents, sweetening, flavoring, and perfuming agents.
  • the liquid dosage form is a mouthwash.
  • such liquid oral dosage forms are useful for local and topical administration to the digestive or GI tract, e.g., digestive tract, e.g., oral cavity.
  • Ocular compositions can include, without limitation, one or more of any of the following: viscogens (e.g., Carboxymethylcellulose, Glycerin, Polyvinylpyrrolidone, Polyethylene glycol); Stabilizers (e.g., Pluronic (triblock copolymers), Cyclodextrins); Preservatives (e.g., Benzalkonium chloride, ETDA, SofZia (boric acid, propylene glycol, sorbitol, and zine chloride; Alcon Laboratories, Inc.), Purite (stabilized oxychloro complex; Allergan, Inc.)).
  • viscogens e.g., Carboxymethylcellulose, Glycerin, Polyvinylpyrrolidone, Polyethylene glycol
  • Stabilizers e.g., Pluronic (triblock copolymers), Cyclodextrins
  • Preservatives e.g., Benzalkonium chloride, ETDA, So
  • the chemical entities described herein or a pharmaceutical composition thereof are suitable for local and topical administration to skin (e.g., ointments and creams).
  • Ointments are semisolid preparations that are typically based on petrolatum or other petroleum derivatives.
  • Creams containing the selected active agent are typically viscous liquid or semisolid emulsions, often either oil-in-water or water-in-oil.
  • Cream bases are typically water-washable, and contain an oil phase, an emulsifier and an aqueous phase.
  • the oil phase also sometimes called the “internal” phase, is generally comprised of petrolatum and a fatty alcohol such as cetyl or stearyl alcohol; the aqueous phase usually, although not necessarily, exceeds the oil phase in volume, and generally contains a humectant.
  • the emulsifier in a cream formulation is generally a nonionic, anionic, cationic or amphoteric surfactant.
  • an ointment base should be inert, stable, nonirritating and non-sensitizing.
  • the dosages may be varied depending on the requirement of the patient, the severity of the condition being treating and the particular compound being employed. Determination of the proper dosage for a particular situation can be determined by one skilled in the medical arts.
  • the total daily dosage may be divided and administered in portions throughout the day or by means providing continuous delivery.
  • a niclosamide compound is administered is administered at a dosage of from about 0.01 mg/Kg to about 200 mg/Kg (e.g., from about 0.01 mg/Kg to about 150 mg/Kg; from about 0.01 mg/Kg to about 100 mg/Kg; from about 0.01 mg/Kg to about 50 mg/Kg; from about 0.01 mg/Kg to about 10 mg/Kg; from about 0.01 mg/Kg to about 5 mg/Kg; from about 0.1 mg/Kg to about 200 mg/Kg; from about 0.1 mg/Kg to about 150 mg/Kg; from about 0.1 mg/Kg to about 100 mg/Kg; from about 0.1 mg/Kg to about 50 mg/Kg; from about 0.1 mg/Kg to about 10 mg/Kg; from about 0.1 mg/Kg to about 5 mg/Kg).
  • a niclosamide compound is administered is administered at a dosage of from about 0.01 mg/Kg to about 200 mg/Kg (e.g., from about
  • the niclosamide compound is administered at a dosage of from about 15 mg/Kg to about 100 mg/Kg (e.g., from about 15 mg/Kg to about 90 mg/Kg, from about 20 mg/Kg to about 100 mg/Kg; from about 20 mg/Kg to about 90 mg/Kg; from about 20 mg/Kg to about 80 mg/Kg; from about 30 mg/Kg to about 90 mg/Kg; from about 30 mg/Kg to about 80 mg/Kg; from about 35 mg/Kg to about 75 mg/Kg; from about 10 mg/Kg to about 50 mg/Kg; from about 15 mg/Kg to about 45 mg/Kg; e.g., about 35 mg/Kg or about 75 mg/Kg).
  • a dosage of from about 15 mg/Kg to about 100 mg/Kg e.g., from about 15 mg/Kg to about 90 mg/Kg, from about 20 mg/Kg to about 100 mg/Kg; from about 20 mg/Kg to about 90
  • the chemical entity is administered at a dosage of from about 0.1 mg/Kg to about 10 mg/Kg (e.g., from about 0.1 mg/Kg to about 5 mg/Kg; from about 1 mg/Kg to about 10 mg/Kg; from about 1 mg/Kg to about 5 mg/Kg).
  • formulations include from about 0.5 mg to about 2500 mg (e.g., from about 0.5 mg to about 2000 mg, from about 0.5 mg to about 1000 mg, from about 0.5 mg to about 750 mg, from about 0.5 mg to about 600 mg, from about 0.5 mg to about 500 mg, from about 0.5 mg to about 400 mg, from about 0.5 mg to about 300 mg, from about 0.5 mg to about 200 mg; e.g., from about 5 mg to about 2500 mg, from about 5 mg to about 2000 mg, from about 5 mg to about 1000 mg; from about 5 mg to about 750 mg; from about 5 mg to about 600 mg; from about 5 mg to about 500 mg; from about 5 mg to about 400 mg; from about 5 mg to about 300 mg; from about 5 mg to about 200 mg; e.g., from about 50 mg to about 2000 mg, from about 50 mg to about 1000 mg, from about 50 mg to about 750 mg, from about 50 mg to about 600 mg, from about 50 mg to about 500 mg, from about 50 mg to about 400 mg, from about 50 mg
  • formulations include from about 50 mg to about 250 mg (e.g., from about 100 mg to about 200; e.g., about 150 mg) of the niclosamide compound.
  • enema formulations include from about 350 mg to about 550 mg (e.g., from about 400 mg to about 500; e.g., about 450 mg) of the niclosamide compound.
  • dosages can be administered on a daily basis (e.g., as a single dose per day; or as two or more divided doses per day; or a two or more doses; e.g., two doses per day) or non-daily basis (e.g., every other day, every two days, every three days, once weekly, twice weeks, once every two weeks, once a month).
  • dosages can be administered for about 1 week, about 2 weeks, about 3 weeks, about 4 weeks, about 5 weeks, about 6 weeks, about 7 weeks, about 8 weeks, about 3 months, about 6 months, about 1 year, or beyond.
  • dosages e.g., about 2.5 mg/mL or about 7.5 mg/mL
  • the chemical entity is niclosamide, or a pharmaceutically acceptable salt and/or hydrate and/or cocrystal thereof.
  • about 2.5 mg/mL or about 7.5 mg/mL of niclosamide in liquid carrier can be administered twice a day on a daily basis for about 6 weeks.
  • Representative liquid carriers include, e.g., those previously described in conjunction with component (ii).
  • the methods consist essentially or consist of the contacting step described above in this paragraph.
  • methods for treating a subject having a condition associated with unregulated (abnormal, elevated) recruitment and/or retention of one or more T cells are provided.
  • the methods include contacting the one or more T cells with an effective amount of a niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof, e.g., a compound, such as niclosamide, or a pharmaceutically acceptable salt and/or cocrystal thereof) as defined anywhere herein.
  • the methods consist essentially of or consist of the contacting step described above in this paragraph.
  • methods for treating a subject having a condition associated with unregulated (abnormal, elevated) activation of one or more T cells (e.g., in the digestive and/or gastrointestinal tract (GI), e.g., colon) of the subject are provided.
  • the methods include contacting the one or more activated T cells with an effective amount of a cocrystal comprising (i) niclosamide compound, or a pharmaceutically acceptable salt thereof, e.g., a compound, such as niclosamide, or a pharmaceutically acceptable salt); and (ii) one or more pharmaceutically acceptable coformers as defined anywhere herein.
  • the methods consist essentially of or consist of the contacting step described above in this paragraph.
  • inducing cell death of the one or more T cells includes one or more of the following pathways: Programmed cell death, Necroptosis, Apoptosis, Necrosis, Pyroptosis, Ferroptosis, Anoikis, Mitotic cathastrophe, Paraptosis, Pyronecrosis, Entosis, Netosis, Parthanatos, Autophagic cell death, RGD: regulated cell death, Non-apoptotic programmed cell-death, Caspase-independent programmed cell-death inducing necrosis or apoptosis of the one or more T cells, e.g., necrosis or apoptosis of the one or more T cells.
  • the effective amount is an amount sufficient to induce cell death of at least one of the one or more T cells (e.g., by any one or more of the pathways described above, e.g., necrosis or apoptosis of the one or more T cells).
  • the one or more T cells include one or more activated T cells, e.g., one or more activated T cells is independently selected from the group consisting of:
  • the effective amount is an amount sufficient to induce cell death of at least one of the one or more activated T cells (e.g., by any one or more of the pathways described above, e.g., necrosis or apoptosis of the one or more activated T cells).
  • the one or more T cells are present within the intestinal epithelium and/or within the lamina intestinal and/or within the Peyer's patches (PP) and/or within the GALT (gut associated lymphoid tissue) and/or within the intestinal mucosa and/or within the intestinal submucosa and/or within the intestinal muscular layer and/or within the intestinal serosa.
  • PP Peyer's patches
  • GALT gut associated lymphoid tissue
  • the one or more T cells comprise one or more gut tropic T cells.
  • each of the one or more gut tropic T cells independently expresses one or more gut-homing receptors selected from the group consisting of:
  • CD3+CCR10+ CD3+CCR10+.
  • methods for treating a condition (or one or more symptoms thereof) characterized by an abnormal inflammatory response in a subject in need thereof are provided (e.g., an autoimmune disorder, e.g., colitis, e.g., autoimmune colitis, e.g., an inflammatory bowel disease; e.g., Crohn's disease or ulcerative colitis).
  • the methods include administering to the subject an effective amount of a chemical entity (e.g., niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof; e.g., a compound, such as niclosamide, or a pharmaceutically acceptable salt and/or cocrystal thereof)) as defined anywhere herein.
  • the methods consist essentially of or consist of the administering step described above in this paragraph.
  • methods for treating a condition (or one or more symptoms thereof) characterized by an abnormal inflammatory response in a subject in need thereof are provided (e.g., an autoimmune disorder, e.g., colitis, e.g., autoimmune colitis, e.g., an inflammatory bowel disease; e.g., Crohn's disease or ulcerative colitis).
  • the methods include topically and locally administering to the subject an effective amount of a chemical entity (e.g., niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof, e.g., a compound, such as niclosamide, or a pharmaceutically acceptable salt and/or cocrystal thereof) as defined anywhere herein.
  • the methods consist essentially of or consist of the administering step described above in this paragraph.
  • a chemical entity e.g., a niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof
  • the methods consist essentially of or consist of the administering step described above in this paragraph.
  • methods for treating a condition selected from the group consisting of celiac disease, irritable bowel syndrome, mucositis, uveitis, collagenous colitis, lymphocytic colitis, microscopic colitis, radiation enteritis, rheumatoid arthritis, lupus, scleroderma, psoriasis, cutaneous T-cell lymphoma, acute graft vs. host disease and chronic graft vs. host disease in a subject are provided.
  • a condition selected from the group consisting of celiac disease, irritable bowel syndrome, mucositis, uveitis, collagenous colitis, lymphocytic colitis, microscopic colitis, radiation enteritis, rheumatoid arthritis, lupus, scleroderma, psoriasis, cutaneous T-cell lymphoma, acute graft vs. host disease and chronic graft vs. host disease in
  • the methods include administering to the subject an effective amount of a chemical entity (e.g., a niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof; e.g., a compound, such as niclosamide, or a pharmaceutically acceptable salt and/or cocrystal thereof) as defined anywhere herein.
  • a chemical entity e.g., a niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof
  • the methods consist essentially of or consist of the administering step described above in this paragraph.
  • the condition is colitis, e.g., autoimmune colitis.
  • the autoimmune colitis can be an inflammatory bowel disease.
  • the inflammatory bowel disease can be Crohn's disease.
  • the inflammatory bowel disease can be ulcerative colitis.
  • the colitis e.g., autoimmune colitis
  • the iatrogenic autoimmune colitis can result from Clostridium difficile infection, which is amond the leading cause of nosocomial diarrhea and colitis in the industrialized world and typically occurs in subjects taking broad spectrum antibiotics.
  • the colitis can be collagenous colitis, lymphocytic colitis, or microscopic colitis.
  • the condition is an autoimmune disease.
  • the condition is autoimmune colitis, e.g., an inflammatory bowel disease (e.g., Crohn's disease or ulcerative colitis).
  • the condition is Crohn's disease, autoimmune colitis, iatrogenic autoimmune colitis, ulcerative colitis, colitis induced by one or more chemotherapeutic agents, colitis induced by treatment with adoptive cell therapy, colitis associated by one or more alloimmune diseases (such as graft-vs-host disease, e.g., acute graft vs. host disease and chronic graft vs. host disease), radiation enteritis, collagenous colitis, lymphocytic colitis, microscopic colitis, and radiation enteritis.
  • graft-vs-host disease e.g., acute graft vs. host disease and chronic graft vs. host disease
  • radiation enteritis collagenous colitis, lymphocytic colitis, microscopic colitis, and radiation
  • the condition is alloimmune disease (such as graft-vs-host disease, e.g., acute graft vs. host disease and chronic graft vs. host disease), celiac disease, irritable bowel syndrome, rheumatoid arthritis, lupus, scleroderma, psoriasis, cutaneous T-cell lymphoma, uveitis, and mucositis (e.g., oral mucositis, esophageal mucositis or intestinal mucositis).
  • graft-vs-host disease e.g., acute graft vs. host disease and chronic graft vs. host disease
  • celiac disease e.g., acute graft vs. host disease and chronic graft vs. host disease
  • celiac disease e.g., acute graft vs. host disease and chronic graft vs. host disease
  • the condition is autoimmune colitis.
  • the autoimmune colitis is induced by one or more chemotherapeutic agents, e.g., a chemotherapeutic immunomodulator, e.g., an immune checkpoint inhibitor.
  • the immune checkpoint inhibitor targets an immune checkpoint receptor selected from the group consisting of CTLA-4, PD-1, PD-L1, PD-1-PD-L1, PD-1-PD-L2, interleukin-2 (IL-2), indoleamine 2,3-dioxygenase (IDO), IL-10, transforming growth factor- ⁇ (TGF ⁇ ), T cell immunoglobulin and mucin 3 (TIM3 or HAVCR2), Galectin 9-TIM3, Phosphatidylserine-TIM3, lymphocyte activation gene 3 protein (LAG3), MHC class II-LAG3, 4-1BB-4-1BB ligand, OX40-OX40 ligand, GITR, GITR ligand-GITR, CD27, CD70-CD
  • chemotherapeutic agents e.
  • the immune checkpoint inhibitor is selected from the group consisting of: Urelumab, PF-05082566, MEDI6469, TRX518, Varlilumab, CP-870893, Pembrolizumab (PD1), Nivolumab (PD1), Atezolizumab (formerly MPDL3280A) (PDL1), MEDI4736 (PD-L1), Avelumab (PD-L1), PDR001 (PD1), BMS-986016, MGA271, Lirilumab, IPH2201, Emactuzumab, INCB024360, Galunisertib, Ulocuplumab, BKT140, Bavituximab, CC-90002, Bevacizumab, and MNRP1685A, and MGA271.
  • the immune checkpoint inhibitor targets CTLA-4, e.g., an antibody, e.g., ipilimumab or tremelimumab.
  • the immune checkpoint inhibitor targets PD1 or PD-L1, e.g., nivolumab, lambroizumab, or BMS-936559.
  • the condition is mucositis, also known as stomatitits, which can occur as a result of chemotherapy or radiation therapy, either alone or in combination as well as damage caused by exposure to radiation outside of the context of radiation therapy.
  • Chemotherapeutic agents which may induce mucositis when used alone or in combination include, but are not limited to, platinum, cisplatin, carboplatin, oxaliplatin, mechlorethamine, cyclophosphamide, chlorambucil, azathioprine, mercaptopurine, vincristine, vinblastine, vinorelbine, vindesine, etoposide and teniposide, paclitaxel, docetaxel, irinotecan, topotecan, amsacrine, etoposide, etoposide phosphate, teniposide, 5-fluorouracil, leucovorin, methotrexate, gemcitabine, taxane, leucovor
  • the condition is uveitis, which is inflammation of the uvea (e.g., anterior uveitis, e.g., iridocyclitis or LTDis; intermediate uveitis (also known as pars planitis); posterior uveitis; or chorioretinitis, e.g., pan-uveitis).
  • uveitis inflammation of the uvea
  • anterior uveitis e.g., iridocyclitis or ulceris
  • intermediate uveitis also known as pars planitis
  • posterior uveitis e.g., pan-uveitis
  • chorioretinitis e.g., pan-uveitis
  • This disclosure contemplates both monotherapy regimens as well as combination therapy regimens.
  • monotherapy includes administering (e.g., topically and locally) to a subject an effective amount of a chemical entity (e.g., a niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof; e.g., a compound, such as niclosamide, or a pharmaceutically acceptable salt and/or cocrystal thereof)) as defined anywhere herein, but excludes the administration of other therapeutic agents (e.g., the active compounds, e.g., peptides, disclosed in U.S. Pat. No. 8,148,328, which is incorporated herein by reference in its entirety).
  • a chemical entity e.g., a niclosamide compound, or a pharmaceutically acceptable salt and/or cocrystal thereof; e.g., a compound, such as niclosamide, or a pharmaceutically acceptable salt and/or cocrystal thereof
  • other therapeutic agents e.g., the active compounds, e.g., peptides, disclosed in U.S
  • the methods described herein can further include administering a second therapeutic agent or regimen.
  • the second therapeutic agent or regimen is administered to the subject prior to contacting with or administering the chemical entity (e.g., about one hour prior, or about 6 hours prior, or about 12 hours prior, or about 24 hours prior, or about 48 hours prior, or about 1 week prior, or about 1 month prior).
  • the chemical entity e.g., about one hour prior, or about 6 hours prior, or about 12 hours prior, or about 24 hours prior, or about 48 hours prior, or about 1 week prior, or about 1 month prior.
  • the second therapeutic agent or regimen is administered to the subject at about the same time as contacting with or administering the chemical entity.
  • the second therapeutic agent or regimen and the chemical entity are provided to the subject simultaneously in the same dosage form.
  • the second therapeutic agent or regimen and the chemical entity are provided to the subject concurrently in separate dosage forms.
  • the second therapeutic agent or regimen is administered to the subject after contacting with or administering the chemical entity (e.g., about one hour after, or about 6 hours after, or about 12 hours after, or about 24 hours after, or about 48 hours after, or about 1 week after, or about 1 month after).
  • the chemical entity e.g., about one hour after, or about 6 hours after, or about 12 hours after, or about 24 hours after, or about 48 hours after, or about 1 week after, or about 1 month after.
  • the second therapeutic agent is a chemotherapeutic immunomodulator, e.g., an immune checkpoint inhibitor, which can be as defined anywhere herein.
  • the second therapeutic agent or regimen is one or more anti-inflammatory agents or immunomodulator acting locally in the GI tract.
  • the second therapeutic agent or regimen is 5-ASA (and associated delivery systems), anti-SMAD7 antisense, orally formulated anti-TNFs, anti-integrins, sulfasalazine, balsalazide, steroids, azathioprine, and methotrexate.
  • the second therapeutic agent or regimen is radiation or surgery.
  • the second therapeutic agent is platinum, cisplatin, carboplatin, oxaliplatin, mechlorethamine, cyclophosphamide, chlorambucil, azathioprine, mercaptopurine, vincristine, vinblastine, vinorelbine, vindesine, etoposide and teniposide, paclitaxel, docetaxel, irinotecan, topotecan, amsacrine, etoposide, etoposide phosphate, teniposide, 5-fluorouracil, leucovorin, methotrexate, gemcitabine, taxane, leucovorin, mitomycin C, tegafur-uracil, idarubicin, fludarabine, mitoxantrone, ifosfamide and doxorubicin.
  • Additional agents include inhibitors of mTOR (mammalian target of rapamycin), including but not limited to
  • the methods and compositions described herein are suitable for use in combination therapy with various other therapeutic regimens (e.g., chemotherapy and/or radiation).
  • the chemical entities and methods described herein can be used to treat side effects produced by such therapeutic regimens, e.g., inflammatory bowel diseases induced by chemotherapeutic immunomodulators, e.g., checkpoint inhibitors, which in some cases can be prohibitively severe.
  • the methods and compositions described herein are suitable for use in combination therapy with one or more additional therapeutic agents.
  • the one or more additional therapeutic agents is administered to the subject prior to contacting with or administering the chemical entity (e.g., about one hour prior, or about 6 hours prior, or about 12 hours prior, or about 24 hours prior, or about 48 hours prior, or about 1 week prior, or about 1 month prior).
  • the chemical entity e.g., about one hour prior, or about 6 hours prior, or about 12 hours prior, or about 24 hours prior, or about 48 hours prior, or about 1 week prior, or about 1 month prior.
  • the one or more additional therapeutic agents is administered to the subject at about the same time as contacting with or administering the chemical entity.
  • the second therapeutic agent or regimen and the chemical entity are provided to the subject simultaneously in the same dosage form.
  • the second therapeutic agent or regimen and the chemical entity are provided to the subject concurrently in separate dosage forms.
  • the one or more additional therapeutic agents is administered to the subject after contacting with or administering the chemical entity (e.g., about one hour after, or about 6 hours after, or about 12 hours after, or about 24 hours after, or about 48 hours after, or about 1 week after, or about 1 month after).
  • the chemical entity e.g., about one hour after, or about 6 hours after, or about 12 hours after, or about 24 hours after, or about 48 hours after, or about 1 week after, or about 1 month after.
  • the one or more therapeutic agents can be: budenoside; epidermal growth factor; corticosteroids; cyclosporine; sulfasalazine; aminosalicylates; 6-mercaptopurine; azathioprine; metronidazole; lipoxygenase inhibitors; mesalamine; olsalazine; balsalazide; antioxidants; thromboxane inhibitors; IL-1 receptor antagonists; anti-IL-1 monoclonal antibodies; anti-IL-6 monoclonal antibodies (e.g., anti-IL-6 receptor antibodies and anti-IL-6 antibodies); growth factors; elastase inhibitors; pyridinyl-imidazole compounds; TNF antagonists as described herein; IL-4, IL-10, IL-13 and/or TGF.beta.
  • cytokines or agonists thereof e.g., agonist antibodies
  • IL-11 glucuronide- or dextran-conjugated prodrugs of prednisolone, dexamethasone or budesonide
  • ICAM-1 antisense phosphorothioate oligodeoxynucleotides ISIS 2302; Isis Pharmaceuticals, Inc.
  • soluble complement receptor 1 TP10; T Cell Sciences, Inc.
  • slow-release mesalazine methotrexate
  • antagonists of platelet activating factor (PAF) ciprofloxacin; and/or lignocaine.
  • PAF platelet activating factor
  • the methods and compositions described herein are suitable for use in combination therapy with one or more additional therapeutic agents for treating or preventing inflammatory bowel disease (IBS) (e.g., Crohn's disease, ulcerative colitis).
  • additional therapeutic agents include: sphingosine 1-phosphate (SiP) receptor modulators (e.g., etrasimod or ozanimod); steroidal anti-inflammatory agents (e.g, beclomethasone 17 or budesonide); non-steroidal anti-inflammatory agents (e.g., 5-ASA); receptor-interacting protein kinase 1 (RIPK1) inhibitors (e.g., GSK2982772); EP4 modulators (e.g., KAG-308); toll-like receptor (e.g., TLR4, TLR9) modulators (e.g., JKB-122, cobitolimod); Janus kinase (JAK) inhibitors (e.g., TD-1473, tofacitini
  • SiP sphingo
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating rheumatoid arthritis.
  • Non-limiting examples include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), corticosteroids (e.g, prednisone), disease-modifying antirheumatic drugs (DMARDs; e.g., methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), leflunomide (Arava®), hydroxychloroquine (Plaquenil), PF-06650833, iguratimod, tofacitinib (Xeljanz®), ABBV-599, evobrutinib, and sulfasalazine (Azulfidine®)), and biologics (e.g., abatacept (Orencia®), adalimumab (Humira®),
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating lupus.
  • Non-limiting examples include steroids, topical immunomodulators (e.g., tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®)), thalidomide (Thalomid®), non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), antimalarial drugs (e.g., Hydroxychloroquine (Plaquenil)), corticosteroids (e.g, prednisone) and immunomodulators (e.g., evobrutinib, iberdomide, voclosporin, cenerimod, azathioprine (Imuran®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral, Sandimmune®, Gengraf®), and my
  • non-limiting treatments for systemic lupus erythematosus include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), antimalarial drugs (e.g., Hydroxychloroquine (Plaquenil)), corticosteroids (e.g, prednisone) and immunomodulators (e.g., iberdomide, voclosporin, azathioprine (Imuran®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral, Sandimmune®, Gengraf®), and mycophenolate mofetil, baricitinb, filogotinib, and PF-06650833), and biologics (e.g., belimumab (Benlysta®), anifrolumab, prezalumab, MEDIO700, vobarilizumab, l
  • non-limiting examples of treatments for cutaneous lupus include steroids, immunomodulators (e.g., tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®)), GS-9876, filogotinib, and thalidomide (Thalomid®).
  • agents and regimens for treating drug-induced and/or neonatal lupus can also be administered.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating IBDs.
  • Non-limiting examples include 6-mercaptopurine, AbGn-168H, ABX464, ABT-494, adalimumab, AJM300, alicaforsen, AMG139, anrukinzumab, apremilast, ATR-107 (PF0530900), autologous CD34-selected peripheral blood stem cells transplant, azathioprine, bertilimumab, BI 655066, BMS-936557, certolizumab pegol (Cimzia®), cobitolimod, corticosteroids (e.g., prednisone, Methylprednisolone, prednisone), CP-690,550, CT-P13, cyclosporine, DIMS0150, E6007, E6011, etrasimod, etrolizumab, fecal microbial transplantation, fig
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating irritable bowel syndrome.
  • Non-limiting examples include alosetron, bile acid sequesterants (e.g., cholestyramine, colestipol, colesevelam), chloride channel activators (e.g., lubiprostone), coated peppermint oil capsules, desipramine, dicyclomine, ebastine, eluxadoline, farnesoid X receptor agonist (e.g., obeticholic acid), fecal microbiota transplantation, fluoxetine, gabapentin, guanylate cyclase-C agonists (e.g., linaclotide, plecanatide), ibodutant, imipramine, JCM-16021, loperamide, lubiprostone, nortriptyline, ondansetron, opioids, paroxetine, pinaverium, polyethylene glycol, pregabalin
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating scleroderma.
  • Non-limiting examples include non-steroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen), corticosteroids (e.g, prednisone), immunomodulators (e.g., azathioprine, methotrexate (Trexall®, Otrexup®, Rasuvo®, Rheumatrex®), cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral®, Sandimmune®, Gengraf®), antithymocyte globulin, mycophenolate mofetil, intravenous immunoglobulin, rituximab, sirolimus, and alefacept), calcium channel blockers (e.g., nifedipine), alpha blockers, serotonin receptor antagonists, angiotens,
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating Crohn's Disease (CD).
  • CD Crohn's Disease
  • Non-limiting examples include adalimumab, autologous CD34-selected peripheral blood stem cells transplant, 6-mercaptopurine, azathioprine, certolizumab pegol (Cimzia®), corticosteroids (e.g., prednisone), etrolizumab, E6011, fecal microbial transplantation, figlotinib, guselkumab, infliximab, IL-2, JAK inhibitors, matrix metalloproteinase 9 (MMP 9) inhibitors (e.g., GS-5745), MEDI2070, mesalamine, methotrexate, natalizumab, ozanimod, RHB-104, rifaximin, risankizumab, SHP647, sulfasalazin
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating UC.
  • Non-limiting examples include AbGn-168H, ABT-494, ABX464, apremilast, PF-00547659, PF-06687234, 6-mercaptopurine, adalimumab, azathioprine, bertilimumab, brazikumab (MEDI2070), cobitolimod, certolizumab pegol (Cimzia®), CP-690,550, corticosteroids (e.g., multimax budesonide, Methylprednisolone), cyclosporine, E6007, etrasimod, etrolizumab, fecal microbial transplantation, figlotinib, guselkumab, golimumab, IL-2, IMU-838, infliximab, matrix metalloproteinase 9 (MMP9) inhibitor
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating autoimmune colitis.
  • agents/regimen for treating autoimmune colitis include corticosteroids (e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating iatrogenic autoimmune colitis.
  • agent/regimen for treating iatrogenic autoimmune colitis.
  • Non-limiting examples include corticosteroids (e.g., budesonide, prednisone, prednisolone, Beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating colitis induced by one or more chemotherapeutics agents.
  • chemotherapeutics agents include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, mesalamine, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating colitis induced by treatment with adoptive cell therapy.
  • agents/regimen for treating colitis induced by treatment with adoptive cell therapy.
  • Non-limiting examples include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), diphenoxylate/atropine, infliximab, loperamide, TIP60 inhibitors (see, e.g., U.S. Patent Application Publication No. 2012/0202848), and vedolizumab.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating colitis associated with one or more alloimmune diseases.
  • agents/regimens include corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), sulfasalazine, and eicopentaenoic acid.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating radaiation enteritis.
  • Non-limiting examples include teduglutide, amifostine, angiotensin-converting enzyme (ACE) inhibitors (e.g., benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril), probiotics, selenium supplementation, statins (e.g., atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and pitavastatin), sucralfate, and vitamin E.
  • statins e.g., atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and pitavastatin
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating collagenous colitis.
  • Non-limiting examples include 6-mercaptopurine, azathaioprine, bismuth subsalicate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • loperamide mesalamine, methotrexate, probiotics, and sulfasalazine.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating lyphocytic colitis.
  • agents/regimen for treating lyphocytic colitis include 6-mercaptopurine, azathioprine, bismuth subsalicylate, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), loperamide, mesalamine, methotrexate, and sulfasalazine.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating microscopic colitis.
  • agents/regimen for treating microscopic colitis include 6-mercaptopurine, azathioprine, bismuth subsalicylate, Boswellia serrata extract, cholestyramine, colestipol, corticosteroids (e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate), fecal microbial transplantation, loperamide, mesalamine, methotrexate, probiotics, and sulfasalazine.
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • corticosteroids e.g., budesonide, prednisone, prednisolone, beclometasone dipropionate
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating alloimmune disease.
  • Non-limiting examples include intrauterine platelet transfusions, intravenous immunoglobin, maternal steroids, abatacept, alemtuzumab, alpha1-antitrypsin, AMG592, antithymocyte globulin, barcitinib, basiliximab, bortezomib, brentuximab, cannabidiol, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, glasdegib, ibrutinib, IL-2, infliximab, itacitinib, LBH589, maraviroc, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin,
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating multiple sclerosis (MS).
  • MS multiple sclerosis
  • Non-limiting examples include alemtuzumab (Lemtrada®), ALKS 8700, amiloride, ATX-MS-1467, azathioprine, baclofen (Lioresal®), beta interferons (e.g., IFN- ⁇ -1a, IFN- ⁇ -1b), cladribine, corticosteroids (e.g., methylprednisolone), daclizumab, dimethyl fumarate (Tecfidera®), fingolimod (Gilenya®), fluoxetine, glatiramer acetate (Copaxone®), hydroxychloroquine, ibudilast, idebenone, laquinimod, lipoic acid, losartan, masitinib, MD1003 (biotin), mitoxantrone, montelukast,
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating graft-vs-host disease.
  • Non-limiting examples include abatacept, alemtuzumab, alpha1-antitrypsin, AMG592, antithymocyte globulin, barcitinib, basiliximab, bortezomib, brentuximab, cannabidiol, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, glasdegib, ibrutinib, IL-2, imatinib, infliximab, itacitinib, LBH589, maraviroc, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, pevonedistat, photobiomodul
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating acute graft-vs-host disease.
  • Non-limiting examples include alemtuzumab, alpha-1 antitrypsin, antithymocyte globulin, basiliximab, brentuximab, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, defribrotide, denileukin diftitox, ibrutinib, infliximab, itacitinib, LBH589, mycophenolate mofetil, natalizumab, neihulizumab, pentostatin, photopheresis, ruxolitinib, sirolimus, tacrolimus, and tocilizumab.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating chronic graft vs. host disease.
  • Non-limiting examples include abatacept, alemtuzumab, AMG592, antithymocyte globulin, basiliximab, bortezomib, corticosteroids (e.g., methylprednisone, prednisone), cyclosporine, dacilzumab, denileukin diftitox, glasdegib, ibrutinib, IL-2, imatinib, infliximab, mycophenolate mofetil, pentostatin, photobiomodulation, photopheresis, ruxolitinib, sirolimus, sonidegib, tacrolimus, tocilizumab, and vismodegib.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating celiac disease.
  • agents/regimen for treating celiac disease include AMG 714, AMY01, Aspergillus niger prolyl endoprotease, BL-7010, CALY-002, GBR 830, Hu-Mik-Beta-1, IMGX003, KumaMax, Larazotide Acetate, Nexvan2®, pancrelipase, TIMP-GLIA, vedolizumab, and ZED1227.
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating psoriasis.
  • Non-limiting examples include topical corticosteroids, topical crisaborole/AN2728, topical SNA-120, topical SAN021, topical tapinarof, topical tocafinib, topical IDP-118, topical M518101, topical calcipotriene and betamethasone dipropionate (e.g., MC2-01 cream and Taclonex®), topical ⁇ -3073, topical LEO 90100 (Enstilar®), topical betamethasone dipropriate (Sernivo®), halobetasol propionate (Ultravate®), vitamin D analogues (e.g., calcipotriene (Dovonex®) and calcitriol (Vectical®)), anthralin (e.g., Dritho-scalp® and Dritho-crème®), topic
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating cutaneous T-cell lymphoma.
  • Non-limiting examples include phototherapy (e.g., exposure to sunlight, UVB phototherapy, narrow band UVB phototherapy, Goeckerman therapy, psoralen plus ultraviolet A (PUVA) therapy, and excimer laser), extracorporeal photopheresis, radiation therapy (e.g., spot radiation and total skin body electron beam therapy), stem cell transplant, corticosteroids, imiquimod, bexarotene gel, topical bis-chloroethyl-nitrourea, mechlorethamine gel, vorinostat (Zolinza®), romidepsin (Istodax®), pralatrexate (Folotyn®) biologics (e.g., alemtuzumab (Campath®), brentuximab vedotin (SGN-35), mogamulizumab, and IPH4102).
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating uveitis.
  • agents include corticosteroids (e.g., intravitreal triamcinolone acetonide injectable suspensions), antibiotics, antivirals (e.g., acyclovir), dexamethasone, immunomodulators (e.g., tacrolimus, leflunomide, cyclophosphamide (Cytoxan®, Neosar®, Endoxan®), and cyclosporine (Neoral®, Sandimmune®, Gengraf®), chlorambucil, azathioprine, methotrexate, and mycophenolate mofetil), biologics (e.g., infliximab (Remicade®), adalimumab (Humira®), etanercept (Enbrel®), golimumab (Simponi®), certolizumab (Cimzia®),
  • the one or more additional therapeutic agents is selected from an agent/regimen for treating mucositis.
  • agents/regimen for treating mucositis include AG013, SGX942 (dusquetide), amifostine (Ethyol®), cryotherapy, cepacol lonzenges, capsaicin lozenges, mucoadhesives (e.g., MuGard®) oral diphenhydramine (e.g., Benadry® elixir), oral bioadherents (e.g., polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair®)), oral lubricants (e.g., Oral Balance®), caphosol, Chamomilla recutita mouthwash, edible grape plant exosome, antiseptic mouthwash (e.g., chlorhexidine gluconate (e.g., Peridex® or Periogard®), topical pain relievers (e.g.
  • non-limiting examples of treatments for oral mucositis include AG013, amifostine (Ethyol®), cryotherapy, cepacol lonzenges, mucoadhesives (e.g., MuGard®) oral diphenhydramine (e.g., Benadry® elixir), oral bioadherents (e.g., polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair)), oral lubricants (e.g., Oral Balance®), caphosol, Chamomilla recutita mouthwash, edible grape plant exosome, antiseptic mouthwash (e.g., chlorhexidine gluconate (e.g., Peridex® or Periogard®), topical pain relievers (e.g., lidocaine, benzocaine, dyclonine hydrochloride, xylocaine (e.g., viscous xylocaine 2%
  • non-limiting examples of treatments for esophageal mucositis include xylocaine (e.g., gel viscous Xylocaine 2%).
  • treatments for intestinal mucositis, treatments to modify intestinal mucositis, and treatments for intestinal mucositis signs and symptoms include gastrointestinal cocktail (an acid reducer such aluminum hydroxide and magnesium hydroxide (e.g., Maalox), an antifungal (e.g., nystatin), and an analgesic (e.g., hurricane liquid)).
  • an acid reducer such aluminum hydroxide and magnesium hydroxide (e.g., Maalox)
  • an antifungal e.g., nystatin
  • an analgesic e.g., hurricane liquid
  • the one or more additional therapeutic agents is a chemotherapeutic immunomodulator, e.g., an immune checkpoint inhibitor, which can be as defined anywhere herein.
  • the second therapeutic agent or regimen is one or more anti-inflammatory agents or immunomodulator acting locally in the GI tract.
  • the second therapeutic agent or regimen is 5-ASA (and associated delivery systems), anti-SMAD7 antisense, orally formulated anti-TNFs, anti-integrins, sulfasalazine, balsalazide, steroids, azathioprine, and methotrexate.
  • the second therapeutic agent or regimen is radiation or surgery.
  • the one or more additional therapeutic agents is platinum, cisplatin, carboplatin, oxaliplatin, mechlorethamine, cyclophosphamide, chlorambucil, azathioprine, mercaptopurine, vincristine, vinblastine, vinorelbine, vindesine, etoposide and teniposide, paclitaxel, docetaxel, irinotecan, topotecan, amsacrine, etoposide, etoposide phosphate, teniposide, 5-fluorouracil, leucovorin, methotrexate, gemcitabine, taxane, leucovorin, mitomycin C, tegafur-uracil, idarubicin, fludarabine, mitoxantrone, ifosfamide and doxorubicin.
  • Additional agents include inhibitors of mTOR (mammalian target of rapamycin), including but not
  • the one or more additional therapeutic agents can be selected from those delineated above (see U.S. Pat. No. 7,927,613, which is incorporated herein by reference in its entirety).
  • the one or more additional therapeutic agents can be selected from the compounds that are disclosed generically, sub generically and specifically in any one or more of WO 2004/006906; WO 2006/120178; US 2009/0062396; WO 2012/143377; WO 2012/068274; U.S. Pat. Nos. 7,132,546; 7,989,498; and 8,263,857; each of which is incorporated herein by reference in its entirety.
  • the one or more additional therapeutic agent can be an anthelminthic agent selected from nitazoxanide, closantel, pyrviniurn pamoate, and sainonycin. See, e.g., Senkowski, W., et al., Mol Cancer Ther. 2015, 14, 1504.
  • the methods described herein further include the step of identifying a subject (e.g., a patient) in need of such treatment (e.g., by way of biopsy, endoscopy, or other conventional method known in the art).
  • the chemical entities, methods, and compositions described herein can be administered to certain treatment-resistant patient populations, e.g., one that is nonresponsive or resistant to treatment with an anti-TNFalpha therapy (e.g., Humira, Enbrel, Remicade, Cimzia, Simponi, Enbrel, xanthine derivatives, e.g., pentoxifylline and Bupropion; (R)-DOI, TCB-2, LSD and LA-SS-Az).
  • an anti-TNFalpha therapy e.g., Humira, Enbrel, Remicade, Cimzia, Simponi, Enbrel, xanthine derivatives, e.g., pentoxifylline and Bupropion; (R)-DOI, TCB-2, LSD and LA-SS-Az.
  • the patient is undergoing and/or has undergone treatment with an anti-TNFalpha therapy (e.g., Humira, Enbrel, Remicade, Cimzia, Simponi, Enbrel, xanthine derivatives, e.g., pentoxifylline and Bupropion; (R)-DOI, TCB-2, LSD and LA-SS-Az).
  • an anti-TNFalpha therapy e.g., Humira, Enbrel, Remicade, Cimzia, Simponi, Enbrel, xanthine derivatives, e.g., pentoxifylline and Bupropion; (R)-DOI, TCB-2, LSD and LA-SS-Az).
  • an anti-TNFalpha therapy e.g., Humira, Enbrel, Remicade, Cimzia, Simponi, Enbrel, xanthine derivatives, e.g., pentoxifylline and Bupropion; (
  • niclosamide API that was non-milled with particle size distribution D (0.9) of approximately 30 micrometers and (2) jet-milled (micronized, referred to below as “milled”) niclosamide with a reduced particle size of approximately 5 micrometers.
  • milled jet-milled
  • Rectal administration of non-milled niclosamide results in mean colon tissue niclosamide concentration of 22.55 ng/ml (stdev 14.49) compared to a plasma concentration of 3.93 ng/ml (stdev 1.37) 1 hour following dosing. This difference means that the colon tissue concentration of niclosamide is more than 5-times the plasma concentration at 1 hr.
  • Rectal administration of milled niclosamide results in mean colon tissue niclosamide concentration of 5030 ng/ml (stdev 367) at 1 hour following dosing compared to a plasma concentration of nicolosamide of 6.576 (stdev 4.50) at 1 hour, the time point at which the maximum plasma concentration of niclosamide was measured in this experiment.
  • This difference means that the colon tissue concentration of niclosamide is more than 750-times greater than the maximum measured plasma concentration.
  • Rectal administration of milled niclosamide (22.5 mg) results in mean colon tissue niclosamide concentration of 6090 ng/ml (stdev 2828) compared to a plasma concentration of nicolosamide of 20.24 (stdev 21.00) at 1 hour which is the time point at which the maximum plasma concentration of niclosamide was measured in this experiment.
  • This difference means that the colon tissue concentration of niclosamide is more than 300-times greater then the maximum measured plasma concentration.
  • Rectal administration of milled niclosamide results in mean colon tissue niclosamide concentration of 5030 ng/ml (stdev 367) compared to unmilled niclosamide that results in a mean rectal concentration of 22.55 ng/ml (stdev 14.49) at 1 hour following dosing.
  • This difference means that the colon tissue concentration of niclosamide formulated with milled material is more than 200-times greater than the colon tissue concentration of niclosamide formulated with unmilled material.

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US11793777B2 (en) 2015-09-01 2023-10-24 First Wave Bio, Inc. Methods and compositions for treating conditions associated with an abnormal inflammatory response
US11564896B2 (en) 2020-03-16 2023-01-31 First Wave Bio, Inc. Methods of treatment
US11744812B2 (en) 2020-03-16 2023-09-05 First Wave Bio, Inc. Methods of treatment
WO2024161132A1 (en) * 2023-01-30 2024-08-08 Ucl Business Ltd Interleukin-6 (il-6)/signal transducer and activator of transcription 3 (stat3) pathway inhibitors for use in the treatment of granulomatous diseases
CN117466786A (zh) * 2023-12-25 2024-01-30 湖南一格制药有限公司 盐酸戊乙奎醚杂质及其制备方法

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